Pain Management Coding Alert

Question: I know all about your 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: While you’ll go to the code set most often for patients with migraines, sometimes documentation dictates that you choose another diagnosis code. Often, the other diagnosis codes live in the G43.—set.

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,” according to Codify.
• 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. 

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