FY2027 ICD-10-CM reference
G43: Migraine
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Migraine. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Nonbillable heading. Verified against the official FY2027 order file.
CMS-HCC V28
Not applicable to this nonbillable heading
CMS-HCC V24
Not applicable to this nonbillable heading
ESRD
Not applicable to this nonbillable heading
PACE
Not applicable to this nonbillable heading
RxHCC
Not applicable to this nonbillable heading
HHS-HCC
Not applicable to this nonbillable heading
More specific FY2027 codes
- G43.0: Migraine without auraNonbillable heading
- G43.1: Migraine with auraNonbillable heading
- G43.4: Hemiplegic migraineNonbillable heading
- G43.5: Persistent migraine aura without cerebral infarctionNonbillable heading
- G43.6: Persistent migraine aura with cerebral infarctionNonbillable heading
- G43.7: Chronic migraine without auraNonbillable heading
- G43.A: Cyclical vomitingNonbillable heading
- G43.B: Ophthalmoplegic migraineNonbillable heading
- G43.C: Periodic headache syndromes in child or adultNonbillable heading
- G43.D: Abdominal migraineNonbillable heading
- G43.8: Other migraineNonbillable heading
- G43.9: Migraine, unspecifiedNonbillable heading
- G43.E: Chronic migraine with auraNonbillable heading
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Excludes2
certain conditions originating in the perinatal period (P04-P96)
Source: G00-G99 (chapter, inherited).
Excludes2
certain infectious and parasitic diseases (A00-B99)
Source: G00-G99 (chapter, inherited).
Excludes2
complications of pregnancy, childbirth and the puerperium (O00-O9A)
Source: G00-G99 (chapter, inherited).
Excludes2
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
Source: G00-G99 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: G00-G99 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: G00-G99 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: G00-G99 (chapter, inherited).
Excludes2
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: G00-G99 (chapter, inherited).
Instructional note
the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled
Source: G43 (category, direct).
Instructional note
code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Source: G43 (category, direct).
Excludes1
lower half migraine (G44.00)
Source: G43 (category, direct).
Excludes2
headache NOS (R51.9)
Source: G43 (category, direct).
Excludes2
headache syndromes (G44.-)
Source: G43 (category, direct).
Compare the FY2027 additions, removals and billable-status changes
What does G43 mean in FY2027?
The official ICD-10-CM descriptor is Migraine. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is G43 billable in FY2027?
The FY2027 order file marks G43 as a nonbillable heading. Select a complete billable child code.
Does G43 map to an HCC?
Risk-model mapping is not applicable to this nonbillable heading. Check a complete billable child code.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition