ICD-10 Coding for Visual Migraine(G43.109, G43.B0)
Complete ICD-10-CM coding and documentation guide for Visual Migraine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Visual Migraine
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G43.109 | Migraine with aura, not intractable | Use when the patient experiences bilateral visual aura without intractability. |
|
| G43.B0 | Ophthalmoplegic migraine, not intractable | Use when the patient presents with monocular visual loss and ocular motor nerve palsy. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for visual migraine
Essential facts and insights about Visual Migraine
Primary ICD-10-CM Codes for visual migraine
Decision Criteria
clinical Criteria
- Presence of bilateral visual aura lasting 5-60 minutes.
documentation Criteria
- Detailed description of visual aura and response to treatment.
Applicable To
- Scintillating scotoma
- Fortification spectra
Excludes
- Retinal migraine (G43.B-)
Clinical Validation Requirements
- Bilateral visual disturbances
- Duration of 5-60 minutes
- Normal OCT findings
Code-Specific Risks
- Confusion with retinal migraine
- Incorrect laterality documentation
Coding Notes
- Ensure documentation specifies bilateral visual symptoms and aura characteristics.
G43.B0 - Ophthalmoplegic migraine, not intractable
Use when the patient presents with monocular visual loss and ocular motor nerve palsy.
Applicable To
- Monocular visual loss
- Ocular motor nerve palsy
Excludes
- Migraine with aura (G43.1-)
Clinical Validation Requirements
- Monocular visual symptoms
- Ocular motor nerve involvement
Coding Notes
Document monocular visual symptoms and any associated ocular motor nerve palsy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of migraine with aura
Z86.602Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Visual Migraine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G43.109.
Impact
Clinical: Misdiagnosis of migraine type., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document whether symptoms are unilateral or bilateral.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Ensure documentation specifies laterality and presence of ocular motor symptoms.
Impact
High risk of miscoding due to symptom overlap.
Mitigation Strategy
Regular training on migraine documentation and coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Visual Migraine, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Visual Migraine
Use these documentation templates to ensure complete and accurate documentation for Visual Migraine. These templates include all required elements for proper coding and billing.
Patient with visual aura and headache
Specialty: NeurologyRequired Elements
- Visual symptoms
- Duration
- Laterality
- Associated symptoms
- Treatment response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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