{"code":"G43.011","type":"code","title":"Migraine without aura, intractable, with status migrainosus","codeAlso":[],"includes":[],"modern_v":"official26","codeFirst":[],"excludes1":["chronic migraine without aura (G43.7-)","lower half migraine (G44.00)"],"excludes2":["headache NOS (R51.9)","headache syndromes (G44.-)"],"isBillable":true,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":true,"billableFy2027":true},"inclusionTerms":[],"useAdditionalCode":["code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)"],"clinicalDefinition":"Migraine without aura, intractable, with status migrainosus is a billable ICD-10-CM diagnosis code (G43.011). Excludes1 (not coded here): chronic migraine without aura (G43.7-); lower half migraine (G44.00). Excludes2 (not included here): headache NOS (R51.9); headache syndromes (G44.-). Use additional code: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).","officialDefinition":"Migraine without aura, intractable, with status migrainosus is a billable ICD-10-CM diagnosis code (G43.011). Excludes1 (not coded here): chronic migraine without aura (G43.7-); lower half migraine (G44.00). Excludes2 (not included here): headache NOS (R51.9); headache syndromes (G44.-). Use additional code: code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).","seventhCharacterInstructions":[],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":"","noteProvenance":{"lower half migraine (G44.00)":"G43","headache NOS (R51.9)":"G43","headache syndromes (G44.-)":"G43","code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)":"G43","chronic migraine without aura (G43.7-)":"G43.0","Common migraine":"G43.0","Migraine without aura with refractory migraine":"G43.01"},"hcc":{"mapped":false,"model":"CMS-HCC V28","paymentYear":"2026","categories":[],"otherModels":[{"model":"RxHCC V08","hcc":"166"}]}}