2025 ICD-10-CM code G43.0
(Active) Effective Date: N/A Diseases of the nervous system - Migraine without aura 6 Feed
Migraine without aura (common migraine).
Medical necessity for treatment of migraine without aura is established by the impact of the headaches on the patient's daily life, the severity and frequency of the headaches, and the failure of over-the-counter pain relievers to provide adequate relief.Documentation should clearly demonstrate the impairment caused by the migraines.
Diagnosis of migraine without aura is typically made based on a patient's medical history, symptoms, and a physical and neurological examination. Diagnostic imaging (MRI or CT scan) and laboratory tests may be conducted to rule out other conditions. Treatment focuses on managing symptoms with pain relievers (NSAIDs, triptans, ergots), antiemetics, and preventive medications (beta blockers, antidepressants, anti-seizure drugs).
In simple words: A migraine without aura is a very bad headache that comes on suddenly, often with throbbing pain usually on one side of your head. You may also feel sick to your stomach, throw up, and be bothered by light and sounds.
This code refers to a migraine headache that occurs without the presence of an aura. An aura is a sensory disturbance that can precede a migraine, often involving visual changes such as flashing lights or blind spots. Migraine without aura is characterized by a severe, throbbing headache, typically on one side of the head, accompanied by symptoms like nausea, vomiting, and sensitivity to light and sound.It is the most common type of migraine.
Example 1: A 30-year-old female presents with a throbbing headache on the right side of her head, accompanied by nausea and sensitivity to light. She denies any visual disturbances or other neurological symptoms before the headache began. Based on her symptoms, she is diagnosed with migraine without aura (G43.0)., A 15-year-old male experiences a severe headache, nausea, and vomiting. He has no history of migraines but reports increased stress at school. His neurological examination is normal, and no aura is present. G43.0 is used to code his condition., A 45-year-old male wakes up with a unilateral throbbing headache, phonophobia, and photophobia. This has happened several times before. He reports no aura. His doctor prescribes a triptan and diagnoses him with Migraine without aura (G43.0).
Documentation should include details of the headache characteristics (location, severity, quality), associated symptoms (nausea, vomiting, photophobia, phonophobia), and the absence of aura.The frequency and duration of headaches, any triggers, and family history of migraine should also be noted.
- Specialties:Neurology, Family Medicine, Internal Medicine, Pain Management
- Place of Service:Office, Urgent Care Facility,Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home, Inpatient Hospital,Outpatient Hospital, Home