Neurology & Pain Management Coding Alert

Question: I know that with migraines, aura refers to feelings and symptoms a patient notices shortly before a migraine begins. What are some of the symptoms of aura?

AAPC Forum Participant

Answer: Actually, aura can occur during the migraine as well. According to Cleveland Clinic, aura “symptoms may occur before or during a migraine attack — usually 30 to 60 minutes prior to head pain.” There’s also a chance that the patient could experience only aura symptoms without a headache or another migraine complication.

Signs that a patient might be experiencing aura include:

• Blind spots or scotomas
• Blindness in half of visual field in one or both eyes (hemianopsia)
• Seeing zigzag patterns (fortification spectra)
• Seeing flashing lights (scintilla)
• Feeling prickling skin (paresthesia)
• Seeing things that aren’t really there (hallucinations)
• Trouble speaking or “finding words”
• Feeling dizzy or nauseated  

These symptoms, among others, are grouped to form distinct migraine aura types. Per Cleveland Clinic, here are the most common aura types:

• “Visual aura: This common type causes temporary changes in your vision, like flashing lights or zigzags.
• Sensorimotor aura: These may include feeling a tingling sensation, numbness or weakness in your limbs. A visual aura may or may not happen at the same time.
• Dysphasic aura: This is a less common type. It includes verbal and language changes, like mumbling or slurred speech.”

Chris Boucher, MS, CPC, Senior Development Editor, AAPC