G43.D0
BillableAbdominal migraine, not intractable
HCC Category Mapping
RxHCCHCC 166 — Migraine
0.000What This Code Means
Recurring episodes of abdominal pain that occur as a migraine variant, typically in children, and responds to standard treatment.
Coding Tips
- •Ensure abdominal symptoms are the primary complaint rather than a secondary symptom of typical migraine
- •The '0' indicates not intractable, so document that treatment is effective
Clinical Significance
Abdominal migraine is a recurrent episodic condition characterized by midline abdominal pain, nausea, and vomiting, primarily affecting children but also occurring in adults. It is recognized as a migraine variant and often precedes development of typical migraine headaches later in life. Accurate coding prevents unnecessary gastrointestinal workups and directs treatment toward migraine-specific therapies.
Documentation Requirements
- ✓Recurrent episodes of midline abdominal pain lasting 2-72 hours
- ✓Associated symptoms: nausea, vomiting, anorexia, pallor
- ✓Symptom-free intervals between episodes (complete return to baseline health)
- ✓Exclusion of gastrointestinal, renal, and metabolic causes of recurrent abdominal pain
- ✓Family history of migraine (supports diagnosis)
- ✓Stereotypical pattern to episodes (similar presentation each time)
- ✓Treatment response noted (not intractable)
- ✓At least 2 episodes meeting diagnostic criteria
Commonly Confused Codes
R10.9 (Unspecified abdominal pain) — non-specific symptom; use abdominal migraine code when diagnosis is establishedK58.x (Irritable bowel syndrome) — chronic GI disorder, not episodic with complete symptom-free intervalsR11.15 (Cyclical vomiting syndrome, unrelated to migraine) — vomiting-predominant without abdominal pain focusG43.A0-G43.A1 (Cyclical vomiting in migraine) — vomiting-predominant migraine variant vs. pain-predominant abdominal migraineK59.8 (Other specified functional intestinal disorders) — functional GI disorders lack the episodic migraine pattern
Code Hierarchy
└G43Migraine└G43.DAbdominal migraine└G43.D0Abdominal migraine, not intractable
└G43.D0Abdominal migraine, not intractable