Question: I am having trouble navigating the new ICD-9 codes for migraines. My encounter notes state that the ED physician provided a level-three E/M for a patient who had an "intractable basilar migraine with status migrainosus." I know the
right diagnosis code is in ICD-9 2009, but which one is it?
Illinois Subscriber
Answer: To represent the patient's migraine type, report 346.03 (Migraine with aura; with intractable migraine, so stated, with status migrainosus). For the ED service, use 99283 (Emergency department visit for the evaluation and management of
a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity ...).
ICD-9 2009 features upward of 30 new migraine codes, which means you must be a lot more specific when choosing a diagnosis code for your migraine claims.
Base code: ICD-9 2009 calls for coders to use 346.0x (Migraine with aura) to represent basilar migraines. You should also use 346.0x for:
- classic migraine
- migraine proceeded or accompanied by transient focal neurological phenomena
- migraine-triggered seizures
- migraine with acute-onset aura
- migraine with aura without headache (migraine equivalents)
- migraine with prolonged aura
- migraine with typical aura
- retinal migraine.
You-ll also have to select a fifth digit for this code based on whether or not status migrainosus is present. With 346.0x, choose from these fifth-digit options:
- 0 ��" without mention of intractable migraine without mention of status migrainosus
- 1 ��" with intractable migraine, so stated, without mention of status migrainosus
- 2 ��" without mention of intractable migraine with status migrainosus
- 3 ��" with intractable migraine, so stated, with status migrainosus
