ICD-10 G43
Non-Billable HeaderMigraine
About ICD-10-CM G43
ICD-10-CM code G43 represents Migraine. This is a non-billable header code in the Nervous System chapter (block G43). The 2026 edition of ICD-10-CM G43 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with G43. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- headache NOS (R51.9)
- lower half migraine (G44.00)
Type 2 Excludes
Not included here, the excluded code is not part of G43, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- headache syndromes (G44.-)
Use Additional Code
When coding G43, also report these additional codes when applicable.
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
Medicare LCD Coverage for G43
Local Coverage Determinations (LCDs) from CMS MACs that list G43 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G43.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G43 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with G43
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To G43
Other codes in section G40-G47 (Episodic and paroxysmal disorders).
ICD-10 G43, Billing FAQ
Is ICD-10 code G43 billable? +
No, G43 is a non-billable header code. Use a more specific child code from block G43 when submitting claims.
What codes are Type 1 Excludes for G43? +
Type 1 Excludes (never code together with G43): headache NOS (R51.9); lower half migraine (G44.00)
What codes are Type 2 Excludes for G43? +
Type 2 Excludes (may be coded together when both conditions exist): headache syndromes (G44.-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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