Is ICD-10-CM code G43 billable?

No, G43 (Migraine) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code G43 belong to?

G43 belongs to Chapter 6 of the ICD-10-CM tabular list: G00–G99 (Diseases of the Nervous System).

G43Not billable, use a more specific code below

Migraine

In Episodic and paroxysmal disorders (G40-G47), chapter 6: Diseases of the Nervous System

48 billable codes under G43: 4 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Excludes1: not coded here, use a different code

lower half migraine (G44.00)

Excludes2: not included here, code separately if applicable

headache NOS (R51.9)
headache syndromes (G44.-)

Use additional code: add a second code for this, listed after this one

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers default dominant or nondominant side for hemiplegia and monoplegia, and use and sequencing of G89 pain codes, including postoperative, chronic, and neoplasm-related pain.

Dominant/nondominant side (page 45)
Pain - Category G89 (page 45)

Read Section I.C.6 (page 45)

All codes under G43

G43 can't be used on a claim. Pick a billable code below; grey headings group them.

G43 MS-DRGs

As the principal diagnosis, all 48 billable codes under G43 group to MS-DRG 102 or 103 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to G43

Notes on these codes point to G43.

G44 Excludes2: migraines (G43.-)
G44.1 Excludes2: migraine (G43.-)
G89 Excludes2: migraines (G43.-)
R51 Excludes2: migraine and other headache syndromes (G43-G44)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Migraine

Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of your head. You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.