G43.609 ICD-10-CM Code: Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus
G43.609 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Episodic and paroxysmal disorders (G40-G47)
G43.609
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePersistent migraine aura with cerebral infarction, not intractable, without status migrainosus
A serious type of migraine with visual disturbances that can cause stroke-like symptoms, manageable with treatment, and not currently in a prolonged migraine attack.
Buddy Insight
Persistent migraine aura with cerebral infarction (migrainous infarction) is a serious neurological emergency where migraine aura symptoms are accompanied by confirmed ischemic brain infarction on neuroimaging.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 166
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Persistent migraine aura with cerebral infarction, without refractory migraineInherited from G43.60
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from G00-G99, G43
- certain infectious and parasitic diseases (A00-B99)Inherited from G00-G99, G43
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from G00-G99, G43
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from G00-G99, G43
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from G00-G99, G43
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from G00-G99, G43
- neoplasms (C00-D49)Inherited from G00-G99, G43
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from G00-G99, G43
- headache NOS (R51.9)Inherited from G00-G99, G43
- headache syndromes (G44.-)Inherited from G00-G99, G43
Related Codes
Includes
OfficialNo Includes notes are included in this display for G43.609. Check the code and parent instructions in the Code Book.
Excludes 1
Official- lower half migraine (G44.00)Inherited from G43
Code First
OfficialNo Code First sequencing instructions are included in this display for G43.609. Check the code and parent instructions in the Code Book.
Use Additional
Official- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)Inherited from G43
Code Also
Official- the type of cerebral infarction (I63.-)Inherited from G43.6
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is G43.609 an HCC code?
G43.609 is not in the CMS-HCC V28 or V24 community payment model. G43.609 has a separate mapping under the Part D RxHCC model (HCC 166 (Migraine Headaches)); the applicable result needs member context.
- Code
- G43.609
- Description
- Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work G43.609 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for G43.609
For G43.609, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
G43.609 is the ICD-10-CM diagnosis code for persistent migraine aura with cerebral infarction, not intractable, without status migrainosus. A serious type of migraine with visual disturbances that can cause stroke-like symptoms, manageable with treatment, and not currently in a prolonged migraine attack. G43.609 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).
G43.609 has no mapping under the CMS-HCC V28 or V24 community payment models. G43.609 has a separate mapping under the Part D RxHCC model (HCC 166 (Migraine Headaches)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Confirm that neuroimaging (CT or MRI) documents cerebral infarction related to the migraine aura.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for G43.609 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm that neuroimaging (CT or MRI) documents cerebral infarction related to the migraine aura.
- •The '09' suffix indicates no status migrainosus; ensure the migraine episode is not continuous or has resolved.
Clinical Significance
Persistent migraine aura with cerebral infarction (migrainous infarction) is a serious neurological emergency where migraine aura symptoms are accompanied by confirmed ischemic brain infarction on neuroimaging. This represents one of the most severe migraine complications and demands urgent stroke protocol evaluation and intervention. Accurate coding is essential for capturing disease severity and ensuring appropriate risk adjustment across multiple models.
Documentation Requirements
- ✓Neuroimaging (MRI with diffusion-weighted imaging preferred) confirming cerebral infarction
- ✓Documentation of migraine aura symptoms that persisted and coincided with the infarction
- ✓Temporal relationship establishing aura preceded or accompanied the infarction event
- ✓Exclusion of other causes of cerebral infarction (cardioembolism, large-vessel atherosclerosis)
- ✓Response to treatment noted (not intractable)
- ✓Episode duration noted
- ✓Additional code for the specific cerebral infarction territory (I63.x) should be reported
- ✓Neurological deficit assessment and residual symptoms
Commonly Confused Codes
- •G43.501-G43.519 (Persistent migraine aura WITHOUT cerebral infarction): no infarction on imaging; use when aura persists but brain is not infarcted
- •I63.x (Cerebral infarction): standalone stroke codes; use G43.6xx when infarction occurs in the context of migraine aura
- •G43.401-G43.419 (Hemiplegic migraine): motor weakness from migraine without actual infarction
- •I67.89 (Other cerebrovascular disease): non-specific vascular conditions without migraine context
- •G45.x (Transient cerebral ischemic attacks): reversible ischemia without confirmed infarction