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G43 ICD-10-CM Code: Migraine

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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Episodic and paroxysmal disorders (G40-G47)

G43

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Migraine

Migraine

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
G4Episodic and paroxysmal disorders (G40-G47)
G43Migraine

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G43 in this effective period.

Excludes 2

Official
  • headache NOS (R51.9)
  • headache syndromes (G44.-)

Related Child Codes

Official
G43.0Migraine without aura
G43.1Migraine with aura
G43.4Hemiplegic migraine
G43.5Persistent migraine aura without cerebral infarction
G43.6Persistent migraine aura with cerebral infarction

Includes

Official

ICD-10-CM does not list Includes notes for G43 in this effective period.

Excludes 1

Official
  • lower half migraine (G44.00)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G43 in this effective period.

Use Additional

Official
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Code Also

Official

ICD-10-CM does not list Code Also instructions for G43 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

G43 is the ICD-10-CM diagnosis code for migraine. G43 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering episodic and paroxysmal disorders (g40-g47).

Header codes like G43 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at G43's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G43 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

Excludes 2, Not included here, may code separately

  • headache NOS (R51.9)
  • headache syndromes (G44.-)

Use Additional Code

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Child Codes

Code Hierarchy

G43Migraine
G43Migraine

More on G43

Referenced in blog posts

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