Neurology & Pain Management Coding Alert

Reader Questions:

Remember Prodrome Symptoms for Accurate Migraine Dx

Question: The provider diagnosed the patient with “migraine w/ prodrome, no status migrainosus.” What is migraine with prodrome, and how do I code this encounter?

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Answer: The term “prodrome” could throw you, but it is merely a synonym for aura. So, on your claim, you should report G43.101 (Migraine with aura, not intractable, with status migrainosus).

“Migraine with aura” is a relatively new name for the less common type of migraine headache. Aura refers to feelings and symptoms you notice shortly before the headache begins. Symptoms of aura might include:

  • Blind spots or scotomas
  • Blindness in half of your visual field in one or both eyes (hemianopsia)
  • Seeing zigzag patterns (fortification spectra)
  • Seeing flashing lights (scintilla)
  • Feeling prickling skin (paresthesia)
  • Weakness
  • Seeing things that aren’t really there (hallucinations)

Head’s up: Prodrome isn’t the only synonym for aura. You’ll want to look at migraine with aura ICD-10 codes if you see any of the following terms in the provider’s notes:

  • Basilar migraine
  • Classical migraine
  • Migraine equivalents
  • Migraine preceded 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.