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G43.119

Billable

Migraine with aura, intractable, without status migrainosus

HCC Category Mapping

RxHCCHCC 166Migraine
0.000

What This Code Means

A severe, difficult-to-treat migraine with warning signs (aura) that does not progress to a prolonged migraine state.

Coding Tips

  • Intractable migraines with aura require documentation of failed treatment attempts
  • The '9' indicates absence of status migrainosus

Clinical Significance

Migraine with aura, intractable, without status migrainosus captures patients with drug-resistant classic migraines that do not extend beyond 72 hours. These patients experience frequent, difficult-to-treat migraines preceded by aura and have failed standard preventive and acute treatments. They are candidates for advanced migraine therapies including CGRP inhibitors, neuromodulation, and Botox injections.

Documentation Requirements

  • Confirmed migraine with aura diagnosis with aura type description
  • Documentation of intractability with list of failed medications
  • Absence of status migrainosus (episodes not exceeding 72 hours)
  • Migraine frequency and headache days per month
  • Functional impact and disability assessment (MIDAS score or similar)
  • Current and planned treatment approaches

Commonly Confused Codes

Code Hierarchy

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