G43.019
BillableMigraine without aura, intractable, without status migrainosus
HCC Category Mapping
RxHCCHCC 166 — Migraine
0.000What This Code Means
A severe, difficult-to-treat migraine headache without warning signs (aura) that does not progress to a prolonged migraine state.
Coding Tips
- •Intractable means the migraine is resistant to treatment; ensure documentation supports this severity level
- •The '9' indicates no status migrainosus (prolonged migraine lasting >72 hours)
Clinical Significance
Migraine without aura, intractable, without status migrainosus identifies patients with drug-resistant migraines that do not reach the 72-hour continuous threshold. These patients have chronic, difficult-to-treat migraines that significantly impact quality of life and productivity. They may be candidates for newer therapies including CGRP monoclonal antibodies, neuromodulation devices, or Botox injections.
Documentation Requirements
- ✓Confirmed migraine without aura diagnosis
- ✓Documentation of intractability with failed medication trials
- ✓Absence of status migrainosus (episodes <72 hours)
- ✓List of preventive and acute medications tried and failed
- ✓Migraine frequency (number of headache days per month)
- ✓Functional impact assessment
- ✓Current or planned treatment including newer targeted therapies
Commonly Confused Codes
G43.009 — Migraine without aura, NOT intractable; responds to treatmentG43.011 — Migraine without aura, intractable, WITH status migrainosusG43.119 — Migraine WITH aura, intractable; has aura symptomsG43.709 — Chronic migraine without aura, not intractable; different frequency patternG44.41 — Drug-induced headache; medication overuse can mimic intractable migraine
Code Hierarchy
└G43Migraine└G43.0Migraine without aura└G43.01Migraine without aura, intractable└G43.019Migraine without aura, intractable, without status migrainosus
└G43.019Migraine without aura, intractable, without status migrainosus