G43.719
BillableChronic migraine without aura, intractable, without status migrainosus
HCC Category Mapping
RxHCCHCC 166 — Migraine
0.000What This Code Means
A long-term migraine condition without visual disturbances that is difficult to treat and does not respond well to standard medications, and the patient is not currently in a prolonged migraine attack.
Coding Tips
- •Establish intractability through documentation of inadequate response to multiple preventive agents (topiramate, propranolol, amitriptyline, etc.).
- •The '19' suffix indicates intractable without status migrainosus; ensure the current episode is not in status migrainosus phase.
Clinical Significance
Chronic migraine without aura is defined as headache occurring on 15 or more days per month for more than 3 months, with migraine features on at least 8 days. This high-frequency condition significantly impacts quality of life and healthcare utilization, often requiring preventive medications and specialist management. Accurate coding captures the chronicity that differentiates this from episodic migraine and supports appropriate treatment authorization.
Documentation Requirements
- ✓Headache frequency documented: 15 or more headache days per month for >3 months
- ✓At least 8 days per month meeting migraine criteria (unilateral, pulsating, moderate-severe, aggravated by activity)
- ✓Absence of aura symptoms clearly stated (no visual, sensory, or speech disturbances preceding headache)
- ✓Duration of chronic pattern documented (must exceed 3 months)
- ✓Intractability status: failed adequate trials of preventive medications
- ✓Individual attack duration noted
- ✓Medication overuse headache excluded or addressed (common comorbidity)
- ✓Headache diary or frequency log referenced
Commonly Confused Codes
G43.001-G43.019 (Migraine without aura, episodic) — fewer than 15 headache days/month; chronic requires >=15 daysG43.E01-G43.E19 (Chronic migraine WITH aura) — use when aura symptoms are present with chronic patternG44.1 (Vascular headache, not elsewhere classified) — non-specific; always code to specific migraine type when documentedG44.209-G44.229 (Tension-type headache) — different headache characteristics; migraine has specific qualifying featuresG43.901-G43.919 (Migraine, unspecified) — avoid when chronic pattern and aura status are documented
Code Hierarchy
└G43Migraine└G43.7Chronic migraine without aura└G43.71Chronic migraine without aura, intractable└G43.719Chronic migraine without aura, intractable, without status migrainosus
└G43.719Chronic migraine without aura, intractable, without status migrainosus