Anesthesia Coding Alert

Question: I know about standard migraines and I think I have a grip on how to report the proper ICD-10 codes. My question is about the other types of migraines I see in the G43.-- code set. Can you tell me a little more about these migraines, for my diagnosis coding knowledge?

Colorado Subscriber

Answer: Sometimes documentation dictates that you choose a diagnosis code for migraine that isn’t as commonplace as G43.0- (Migraine without aura) or G43.1- (Migraine with aura). These diagnoses are further down in the G43.—code set and have fourth digits that are alphabetic rather than numeric.

Here’s a little more about this small corner of migraine diagnosis coding.

• G43.A- (Cyclical vomiting): In a cyclical vomiting migraine, the patient has repeated episodes of severe nausea and vomiting, which can last from a few hours up to several days, followed by symptom-free periods.
• G43.B- (Ophthalmoplegic migraine): In an ophthalmoplegic migraine (OM), the patient has several episodes of one-sided headache with paralysis of one or more ocular cranial nerves.
• G43.C- (Periodic headache syndromes in child or adult): Periodic headache syndrome involves a patient with episodes of recurring headaches that may be precursors to migraines, severe one-sided headaches associated with nausea, vomiting, and/or painful reaction to bright light and sometimes preceded by visual or other sensory phenomena known as auras.
• G43.D- (Abdominal migraine): In an abdominal migraine, the patient doesn’t suffer from a headache; instead, the symptoms are recurring episodes of moderate to severe abdominal pain.