Primary Care Coding Alert

Question: When I look up chronic migraine in the ICD-10 alphabetic index, I am directed to G43.709, which appears under the “without aura” codes. Does this mean we should assume that chronic migraines are always without aura?

AAPC Forum Participant

Answer: Unfortunately, the only listing for “migraine, chronic” in the ICD-10 index appears under the “without aura” subcategory. Code G43.709 (Chronic migraine without aura, not intractable, without status migrainosus) describes migraines that are not only chronic but also have the following specificity: (1) they occur without auras (without symptoms of visual disturbances), (2) they are not intractable (i.e., they are responsive to treatment), and (3) they occur without other symptoms described by the condition status migrainosus (e.g., vomiting, throbbing head pain, and durations in excess of 72 hours).

If your provider documents of all of these things, then you can use G43.709. And if the patient has not been experiencing auras, you can use another code from G43.7- (Chronic migraine without aura) tailored to the patient’s specific symptoms.

But if your provider has documented chronic migraines with auras and no other specified symptoms, you’ll have to go with G43.909 (Migraine, unspecified, not intractable, without status migrainosus), as ICD-10 designates this code for migraines not otherwise specified.