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G43.909
ICD-10-CM
History of Migraine Headache

Find information on documenting a history of migraine headache for accurate medical coding and clinical care. Learn about relevant diagnostic criteria, including migraine with and without aura, chronic migraine, and related headache disorders. Explore best practices for recording headache frequency, duration, severity, and associated symptoms in patient charts. This resource covers key terminology for healthcare professionals seeking guidance on proper migraine diagnosis documentation and coding for billing and reimbursement purposes. Understand the importance of a comprehensive migraine history in developing effective treatment plans and improving patient outcomes.

Also known as

Migraine History
Past Migraine Episodes

Diagnosis Snapshot

Key Facts
  • Definition : Recurrent headache disorder characterized by moderate to severe throbbing pain, often unilateral.
  • Clinical Signs : Pulsating pain, nausea, vomiting, sensitivity to light and sound, aura (visual disturbances).
  • Common Settings : Outpatient neurology clinics, primary care offices, telehealth consultations, urgent care centers.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC G43.909 Coding
G43

Migraine

Covers all types of migraine headaches, including with and without aura.

G44

Other headache syndromes

Includes other headache types that may be related or misdiagnosed as migraine.

R51

Headache

A general code for headache, usable when migraine type is unspecified.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the migraine active/current?

  • Yes

    Code from G43.x, specify subtype and status (e.g., with aura, without aura, intractable)

  • No

    Is there a history of migraine without aura?

Code Comparison

Related Codes Comparison

When to use each related code

Description
History of Migraine
Migraine without aura
Migraine with aura

Documentation Best Practices

Documentation Checklist
  • Migraine frequency, duration, & severity
  • Location, quality, & character of pain
  • Associated symptoms (aura, nausea, etc.)
  • Impact on daily life/functional status
  • Family history of migraine

Coding and Audit Risks

Common Risks
  • Unspecified Migraine

    Coding G43.909, migraine unspecified, without adequate documentation of migraine type or status can lead to claim denials and lost revenue.

  • Chronic vs Episodic

    Incorrectly coding chronic (G43.A) vs episodic (G43.909) migraine based on headache frequency impacts severity scores and reimbursement.

  • Status Migrainosus

    Failing to capture status migrainosus (G43.111) when documented leads to undercoding of severity and inadequate resource reflection.

Mitigation Tips

Best Practices
  • Document migraine triggers, frequency, duration, and intensity for accurate ICD-10 coding (G43.x).
  • Use specific migraine subtype descriptors (e.g., with aura, without aura) for proper CDI and billing.
  • Ensure consistent documentation of migraine prophylaxis and acute treatment for compliance and quality metrics.
  • Query physician for clarification on unclear migraine documentation to improve coding accuracy and reimbursement.
  • Record family history of migraine for better risk assessment and personalized treatment planning.

Clinical Decision Support

Checklist
  • Verify patient-reported headache frequency/duration aligns with ICHD-3 criteria for migraine diagnosis.
  • Confirm headache characteristics (throbbing, unilateral, etc.) are documented in patient history.
  • Check for associated migraine symptoms nausea, vomiting, photophobia, phonophobia.
  • Rule out secondary headache disorders via appropriate diagnostic workup if indicated.
  • Document migraine triggers and preventative measures discussed if applicable.

Reimbursement and Quality Metrics

Impact Summary
  • **Reimbursement and Quality Metrics Impact Summary: History of Migraine Headache**
  • **Keywords:** Migraine diagnosis coding, ICD-10 G43. History of migraine, medical billing compliance, reimbursement rates, quality reporting, healthcare analytics, hospital revenue cycle
  • **Impacts:**
  • Reduced reimbursements if undocumented migraine specifics (e.g., status migrainosus) are not coded.
  • Impacts physician quality reporting metrics related to chronic pain management.
  • Lower reported migraine prevalence affects resource allocation and population health management.
  • Accurate coding improves data integrity for research and clinical trial eligibility.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code G43.x for migraine
  • Specify migraine type
  • Document frequency/severity
  • Note aura if present
  • Consider comorbidities

Documentation Templates

The patient presents with a history of migraine headaches, fulfilling diagnostic criteria for migraine without aura (ICHD-3 1.1).  Onset of migraines began approximately [duration] ago, with an average frequency of [frequency] per month.  The patient describes their typical headache as [location: unilateral, bilateral, frontal, temporal, occipital, etc.] and [character: throbbing, pulsating, pressing, tight, etc.], with pain intensity rated as [scale: mild, moderate, severe] on a 0-10 scale.  Associated symptoms commonly reported include photophobia, phonophobia, and nausea.  Triggers identified by the patient include [triggers: stress, caffeine withdrawal, specific foods, hormonal fluctuations, etc.].  Prior to presentation, the patient has utilized various acute migraine treatments, including [medications: over-the-counter analgesics, NSAIDs, triptans, ergots, etc.], with [efficacy: complete, partial, no] relief.  The patient denies any history of aura, seizures, or neurological deficits.  Family history is positive for migraine headaches.  A comprehensive neurological examination was normal.  Diagnosis of migraine without aura is confirmed based on patient history, symptom presentation, and absence of red flags.  The patient was educated on migraine management, including lifestyle modifications, trigger avoidance, and appropriate use of acute and preventive medications.  A prescription for [medication and dosage] was provided for acute migraine attacks.  The patient was also advised on the potential benefits of prophylactic therapy if the frequency or severity of migraines does not improve.  Follow-up appointment scheduled in [duration] to reassess treatment efficacy and adjust management plan as needed.