What is ICD-10 code G43.839?

G43.839 is the ICD-10-CM diagnosis code for Menstrual migraine, intractable, without status migrainosus. Migraine headaches that occur around menstrual periods and do not respond well to treatment, without prolonged migraine symptoms. It belongs to the ICD-10-CM chapter for diseases of the nervous system (g00-g99). G43.839 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. G43.839 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. G43.839 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. G43.839 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for G43.839?

G43.839 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards G43.839 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting G43.839?

Intractable migraines require documentation of treatment resistance; note which treatments have failed Confirm status migrainosus is absent before using this code rather than G43.831

G43.839: Menstrual migraine, intractable, without status migrainosus — ICD-10

ICD-10-CM Code View

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Code lookupG43.839Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Episodic and paroxysmal disorders (G40-G47)

G43.839

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Menstrual migraine, intractable, without status migrainosus

Migraine headaches that occur around menstrual periods and do not respond well to treatment, without prolonged migraine symptoms.

Buddy Insight

Menstrual migraine is a hormonally triggered migraine subtype occurring in relation to the menstrual cycle, typically within 2 days before to 3 days after menstruation onset.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 166

Migraine

RAF 0.0

Code Trumping

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Code Book Path

Official

G43.8Other migraine

G43.83Menstrual migraine, intractable

G43.839Menstrual migraine, intractable, without status migrainosus

Inclusion Terms

Official

Menstrual headache, intractable
Menstrual migraine, with refractory migraine
Menstrually related migraine, intractable
Pre-menstrual headache, intractable
Pre-menstrual migraine, intractable

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G43.839 in this effective period.

Related Child Codes

Official

G43.831Menstrual migraine, intractable, with status migrainosus

Includes

Official

ICD-10-CM does not list Includes notes for G43.839 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G43.839 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G43.839 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G43.839 in this effective period.

Code Also

Official

associated premenstrual tension syndrome (N94.3)

Buddy Documentation Tip

HCC Buddy guidance

Temporal relationship to menstrual cycle documented (onset within day -2 to day +3 of menses)

Pattern occurring in at least 2 out of 3 consecutive menstrual cycles

Migraine features present (unilateral, pulsating, moderate-severe intensity, nausea/photophobia)

Distinction between pure menstrual migraine (only perimenstrual) vs. menstrually related migraine (also occurs at other times)

MEAT Support

HCC Buddy guidance

Temporal relationship to menstrual cycle documented (onset within day -2 to day +3 of menses)

Pattern occurring in at least 2 out of 3 consecutive menstrual cycles

Migraine features present (unilateral, pulsating, moderate-severe intensity, nausea/photophobia)

Distinction between pure menstrual migraine (only perimenstrual) vs. menstrually related migraine (also occurs at other times)

Audit Caution

HCC Buddy guidance

Coding as 'migraine without aura' when the provider documents menstrual timing — menstrual migraine has specific codes

Not requiring documentation of the temporal menstrual relationship — migraine that happens to occur during menses is not necessarily menstrual migraine

Applying menstrual migraine codes to post-menopausal patients without hormonal trigger documentation

Missing the intractable designation when standard menstrual migraine preventives have failed

Common Mistakes

HCC Buddy guidance

G43.001-G43.019 (Migraine without aura) — use when migraine is not specifically linked to menstrual cycle timing

G43.101-G43.119 (Migraine with aura) — menstrual migraine typically presents without aura; if aura present, consider dual coding

N94.3 (Premenstrual tension syndrome) — PMS is not migraine; these are distinct conditions though they may coexist

G43.801-G43.819 (Other migraine) — menstrual migraine has its own specific codes; do not use 'other'

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is G43.839 an HCC code?

No. G43.839 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 166, Migraine

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work G43.839 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for G43.839

For G43.839to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

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

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed G43.839 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

G43.839 is the ICD-10-CM diagnosis code for menstrual migraine, intractable, without status migrainosus. Migraine headaches that occur around menstrual periods and do not respond well to treatment, without prolonged migraine symptoms. G43.839 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).

G43.839 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Maps to RxHCC 166 (Severe Head Injury) with a RAF weight of 0.000 in the prescription drug model. No mapping to CMS-HCC V28 or V24 payment models. The RxHCC mapping is relevant given the specific pharmacy costs of menstrual migraine (timed triptan prophylaxis, hormonal interventions). No hierarchies apply.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G43.839 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Intractable migraines require documentation of treatment resistance; note which treatments have failed
•Confirm status migrainosus is absent before using this code rather than G43.831

Clinical Significance

Menstrual migraine is a hormonally triggered migraine subtype occurring in relation to the menstrual cycle, typically within 2 days before to 3 days after menstruation onset. This diagnosis is clinically important because it guides hormone-specific treatment strategies including estrogen supplementation, triptans timed to the menstrual cycle, and contraceptive management. Accurate coding captures the hormonal etiology which affects both treatment planning and pharmacy utilization predictions.

Documentation Requirements

✓Temporal relationship to menstrual cycle documented (onset within day -2 to day +3 of menses)
✓Pattern occurring in at least 2 out of 3 consecutive menstrual cycles
✓Migraine features present (unilateral, pulsating, moderate-severe intensity, nausea/photophobia)
✓Distinction between pure menstrual migraine (only perimenstrual) vs. menstrually related migraine (also occurs at other times)
✓Intractability status: failed menstrual-specific preventive approaches
✓Typical episode duration noted
✓Headache diary correlating attacks with menstrual dates
✓Hormonal medication history (oral contraceptives, hormone replacement therapy)

Commonly Confused Codes

•G43.001-G43.019 (Migraine without aura): use when migraine is not specifically linked to menstrual cycle timing
•G43.101-G43.119 (Migraine with aura): menstrual migraine typically presents without aura; if aura present, consider dual coding
•N94.3 (Premenstrual tension syndrome): PMS is not migraine; these are distinct conditions though they may coexist
•G43.801-G43.819 (Other migraine): menstrual migraine has its own specific codes; do not use 'other'
•G43.901-G43.919 (Migraine, unspecified): avoid when menstrual pattern is documented

Child Codes

G43.831Menstrual migraine, intractable, with status migrainosus

G43.839Menstrual migraine, intractable, without status migrainosus

Code Hierarchy

└G43Migraine └G43.8Other migraine └G43.83Menstrual migraine, intractable └G43.839Menstrual migraine, intractable, without status migrainosus

└G43.839Menstrual migraine, intractable, without status migrainosus

G43.839 ICD-10-CM Code: Menstrual migraine, intractable, without status migrainosus

HCC Buddy Code Card

G43.839

Is G43.839 an HCC code?

HCC Category Mapping

MEAT Criteria for G43.839

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What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

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