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2025 ICD-10-CM code G43.81

Other intractable migraine.A type of migraine not otherwise specified that is resistant to treatment.

Use more specific codes if available. Do not use this code for headaches attributed to another condition.Ensure documentation supports the “intractable” designation, meaning the migraine has not responded to multiple appropriate treatments.

Not applicable.

Medical necessity for further evaluation and management of intractable migraine is established by the failure of standard treatments to adequately control symptoms and the impact of the condition on the patient's quality of life.Documentation of failed treatments is essential.

Diagnosis is typically made by a neurologist or other healthcare provider specializing in headache disorders based on patient history, symptoms, physical and neurological examination.Imaging (MRI, CT) and lab tests may be used to rule out other causes.Treatment may include medication, lifestyle changes, and avoiding triggers.

IMPORTANT:For migraines that are not intractable, use G43.80. More specific codes should be used when available (e.g., G43.0 for migraine without aura, G43.1 for migraine with aura).

In simple words: This refers to a severe, recurring headache, often on one side, that doesn't respond to usual treatments.It may also involve nausea, vomiting, and sensitivity to light, sound, or smells. The specific type of migraine is not otherwise classified (e.g., vestibular or silent migraine).

Other migraine, intractable. This code is used for migraine variants that are not specifically classified elsewhere and are unresponsive to standard treatments.

Example 1: A 35-year-old female presents with a history of severe, unilateral headaches occurring several times a month, accompanied by nausea, vomiting, and photophobia.She has tried multiple preventive and abortive medications without significant relief, including triptans, beta-blockers, and topiramate.Her symptoms are consistent with intractable migraine, and she is referred to a headache specialist for further evaluation and management., A patient experiences vestibular migraine with recurrent episodes of vertigo, dizziness, and imbalance associated with headache.Despite trials of various medications and vestibular therapy, the patient continues to experience debilitating symptoms. The vestibular migraine is considered intractable., A patient presents with a history of silent migraine, experiencing visual auras and other sensory disturbances without headache. These symptoms significantly impact daily life and haven't responded to multiple treatment attempts.The silent migraine is considered intractable.

Documentation should include frequency, duration, and severity of headaches; associated symptoms (nausea, vomiting, aura);list of medications tried and their effectiveness; impact on daily life; and results of any diagnostic testing.It's crucial to clearly document the lack of response to treatment to justify the "intractable" designation.

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