ICD Code G43.719

ICD code G43.719 is a classification used to identify a chronic migraine condition that occurs without an aura, is resistant to treatment (intractable), and does not involve a prolonged migraine attack known as status migrainosus. This code helps healthcare providers document and communicate the specific nature of the migraine for accurate diagnosis, treatment planning, and billing purposes.

1. Chronic Migraine Diagnosis: The patient must have a history of chronic migraines, characterized by headaches occurring on 15 or more days per month for more than three months, with at least eight of those days being migraines.

2. Absence of Aura: The migraines must occur without aura, meaning there are no sensory disturbances such as visual changes, tingling, or speech difficulties that typically precede the headache phase.

3. Intractability: The migraines are considered intractable, indicating that they do not respond adequately to standard migraine treatments, including both acute and preventive therapies.

4. Exclusion of Status Migrainosus: The patient does not experience status migrainosus, which is a debilitating migraine attack lasting more than 72 hours despite treatment.

5. Symptom Consistency: The migraines should consistently present with typical migraine symptoms such as unilateral head pain, pulsating quality, moderate to severe pain intensity, and aggravation by routine physical activity.

6. Associated Symptoms: During the migraine attacks, the patient may experience nausea, vomiting, or sensitivity to light (photophobia) and sound (phonophobia).

7. Exclusion of Other Causes: Other potential causes of the headaches, such as medication overuse or secondary headaches due to another medical condition, should be ruled out to confirm the diagnosis of chronic migraine.

For the ICD code G43.719, which pertains to chronic migraine without aura, intractable, without status migrainosus, the relevant CPT codes that may be applicable for treatment include:

1. CPT 64615 - Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (e.g., for chronic migraine).

2. CPT 96372 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular.

3. CPT 99213 - Established patient office or other outpatient visit, typically 15 minutes.

4. CPT 99214 - Established patient office or other outpatient visit, typically 25 minutes.

5. CPT 99215 - Established patient office or other outpatient visit, typically 40 minutes.

These CPT codes are commonly used in the management and treatment of chronic migraines and may be utilized depending on the specific treatment plan and interventions provided by the healthcare provider. Always ensure that the selected CPT codes accurately reflect the services rendered and are supported by the patient's medical documentation.

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