ICD-10 G43.1
Non-Billable HeaderMigraine with aura
About ICD-10-CM G43.1
ICD-10-CM code G43.1 represents Migraine with aura. This is a non-billable header code in the Nervous System chapter (block G43). The 2026 edition of ICD-10-CM G43.1 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under G43.1. Per CMS ICD-10-CM Tabular 2026.
- Basilar migraine
- Classical migraine
- Migraine equivalents
- Migraine preceded or accompanied by transient focal neurological phenomena
- Migraine triggered seizures
- Migraine with acute-onset aura
- Migraine with aura without headache (migraine equivalents)
- Migraine with prolonged aura
- Migraine with typical aura
- Retinal migraine
Type 1 Excludes
Pure excludes, these codes can never be coded together with G43.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- chronic migraine with aura (G43.E-)
- persistent migraine aura (G43.5-, G43.6-)
Coding Notes
Code Also
- any associated seizure (G40.-, R56.9)
Medicare LCD Coverage for G43.1
Local Coverage Determinations (LCDs) from CMS MACs that list G43.1 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 G43.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G43.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with G43.1
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 G43.1
Other codes in section G40-G47 (Episodic and paroxysmal disorders).
ICD-10 G43.1, Billing FAQ
Is ICD-10 code G43.1 billable? +
No, G43.1 is a non-billable header code. Use a more specific child code from block G43 when submitting claims.
What other names or terms map to G43.1? +
ICD-10 G43.1 includes: Basilar migraine; Classical migraine; Migraine equivalents, and 7 more clinical synonyms.
What codes are Type 1 Excludes for G43.1? +
Type 1 Excludes (never code together with G43.1): chronic migraine with aura (G43.E-); persistent migraine aura (G43.5-, G43.6-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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