G43.009
BillableMigraine without aura, not intractable, without status migrainosus
HCC Category Mapping
RxHCCHCC 166 — Migraine
0.000What This Code Means
Migraine without aura is a common type of headache with throbbing pain, often on one side of the head, sometimes with nausea or light sensitivity. This code indicates the migraine is controlled with treatment and is not prolonged.
Coding Tips
- •Confirm absence of aura symptoms (no visual disturbances or other sensory warnings before headache)
- •Verify migraine duration is less than 72 hours (no status migrainosus)
Clinical Significance
Migraine without aura, not intractable, without status migrainosus is the most common migraine presentation — episodic headaches without prodromal visual/sensory symptoms that respond to treatment. While not an HCC-mapped condition, accurate coding supports prevalence tracking, treatment authorization, and identification of patients at risk for migraine progression or chronic migraine.
Documentation Requirements
- ✓Confirmed migraine diagnosis meeting diagnostic criteria
- ✓Absence of aura symptoms documented
- ✓Statement that migraines respond to treatment (not intractable)
- ✓Migraine duration less than 72 hours (no status migrainosus)
- ✓Headache characteristics (location, quality, severity, associated symptoms)
- ✓Current treatment regimen (acute and preventive if applicable)
Commonly Confused Codes
G43.001 — Same type WITH status migrainosus (>72 hours duration)G43.019 — Same type but INTRACTABLE (drug-resistant)G43.109 — Migraine WITH aura; has visual/sensory warning symptomsG43.909 — Migraine unspecified; avoid when migraine type is documentedG44.209 — Tension-type headache, unspecified; different headache mechanism
Code Hierarchy
└G43Migraine└G43.0Migraine without aura└G43.00Migraine without aura, not intractable└G43.009Migraine without aura, not intractable, without status migrainosus
└G43.009Migraine without aura, not intractable, without status migrainosus