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Does ICD-10 Coding for Migrane Give You a Headache?

Migraine

A common neurological disorder, migraine ends up giving the patient a terrible headache. Migraines can be triggered due to various reasons including hormonal changes in women, stress, skipped meals, loud noises, lack of sleep, bright lights, withdrawal from caffeine and cigarettes, amongst others. Headaches of this type can and usually are accompanied by feelings of nausea, extra sensitivity to sound or lights and/or vomiting. However, it is important to know that other than painful headaches, this neurological disorder can also manifest other symptoms like cyclic vomiting, abdominal pain, visual aura, vertigo, confusion, dysarthria and hemiplegia. These symptoms usually occur in children and teenagers.

This pulsating and unilateral headache results due to neurotransmitter changes and abnormal activity along the nerve pathways in the brain. The neurotransmitter changes in the brain and surrounding tissue, affected by the blood flow, may create warning signals, before the actual pain begins. Migraines are recurring in nature with women more likely to suffer from them than men. It is a fairly common problem with around twelve percent of the US population suffering from it. Fortunately, migraine problems can be prevented by medicines. In case of those suffering from the problem, there are medicines which can help relieve the symptoms and the pain.

Reference: https://www.mdjunction.com/forums/migraine-headaches-discussions/general-support/11830577-fantabulous-friday-funnies

 

ICD 10 code for Migraine headache

Coding for Migraines, has become more complicated under ICD 10. Requiring better specificity and supported documentation, ICD 10 migraine coding is a challenging proposition for both coders and billers. Falling under the block ‘Diseases of the nervous system’ (G00 to G99); subset ‘episodic and paroxysmal disorders’ (G40 to G47) of ICD 10 codes, migraines come under the code G43 with 12 sub categories as under:

CATEGORY CODE
Migraine without aura G43.0
With aura G43.1
Hemiplegic migraine G43.4
Persistent migraine aura without cerebral infarction G43.5
Persistent migraine aura with cerebral infarction G43.6
Chronic migraine without aura G43.7
Cyclical vomiting G43.A
Ophthalmologic migraine G43.B
Periodic headache syndromes in child or adult G43.C
Abdominal migraine G43.D
Other migraine G43.8
Migraine unspecified G43.9

A fifth character in migraine codes differentiates between not intractable (0) and intractable (1). Any of the following terms in the documentation are considered as intractable – pharmacologically resistant, poorly controlled, refractory (medically) and treatment resistant. Other than migraine variants under G43.A to G43.D, other migraine ICD 10 codes can also have a sixth character. This sixth character identifies migraine which has lasted more than 72 hours (1) or migraine which has lasted less than 72 hours (9).

Code G43.8 which specifies other migraine covers the following:

CATEGORY CODE
Other migraine, not intractable G43.80
Other migraine, intractable G43.81
Menstrual migraine, not intractable G43.82
Menstrual migraine, intractable G43.83
Other migraine, not intractable, with status migrainosus G43.801
Other migraine, not intractable, without status migrainosus G43.809
Other migraine, intractable, with status migrainosus G43.811
Other migraine, intractable, without status migrainosus G43.819
Menstrual migraine, not intractable, with status migrainosus G43.821
Menstrual migraine, not intractable, without status migrainosus G43.829
Menstrual migraine, intractable, with status migrainosus G43.831
Menstrual migraine, intractable, without status migrainosus G43.839

Using additional codes

Migraines may be associated with or cause additional conditions and these need to be reported with additional codes. The following examples should help understand this better.

Drugs like oral contraceptives and nitroglycerine can trigger migraines. Thus a migraine without aura, caused due to an effect of nitroglycerine will be reported with two codes – G43.0 (migraine without aura) and T46.3x5A (adverse effect of coronary vasodilators). Although migraines with aura are rarely accompanied by seizures; in case of migraine seizure the reporting codes would be – G43.1 (Migraines with aura) and depending on the type of seizure, codes from either G40 (epilepsy) or R56.9 (unspecified convulsions).

Why MedConverge

While the ICD 10 code for migraine, G43 indicates treatment for migraine; in order to receive payment for the same, the coder has to add three additional characters to the basic code. The sequence of information to provide a complete status of the medical condition requires each additional character to build on the previous character placed before it. The highest degree of specificity is attained by using a total of six characters, if required. Our coders review all available documentation in the patient’s records to build the most accurate codes. Leave your headache of migraine billing to us, while you continue to treat your patient’s headache.


References

  • ICD-10-CM Codes › G00-G99 Diseases of the nervous system › G40-G47 Episodic and paroxysmal disorders › . (2018). Retrieved July 16, 2018, from www.icd10data.com: https://www.icd10data.com/ICD10CM/Codes/G00-G99/G40-G47/G43-
  • Coding Migraine in ICD-10-CM. (2018). Retrieved July 16, 2018, from www.freemedicalcoding.com: https://www.freemedicalcoding.com/resources/medical-billing-for-migraine-in-icd-10/
  • 8. (2018). Retrieved July 16, 2018, from www.icd10data.com: https://www.icd10data.com/search?s=G43.8
  • Headache (Migraine & Chronic) . (2018). Retrieved July 16, 2018, from www.medicalhomeportal.org: https://www.medicalhomeportal.org/diagnoses-and-conditions/headache

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