ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 G43.41

Non-Billable Header

Hemiplegic migraine, intractable

G43
Block
1
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM G43.41

ICD-10-CM code G43.41 represents Hemiplegic migraine, intractable. This is a non-billable header code in the Nervous System chapter (block G43). The 2026 edition of ICD-10-CM G43.41 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 G43.41. Per CMS ICD-10-CM Tabular 2026.

  • Hemiplegic migraine with refractory migraine

Medicare LCD Coverage for G43.41

Local Coverage Determinations (LCDs) from CMS MACs that list G43.41 as a covered diagnosis.

No Medicare LCDs reference G43.41 as covered

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 G43.41.

No commercial payer policies reference G43.41 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G43.41 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with G43.41

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for G43.41

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 G43.41

Other codes in section G40-G47 (Episodic and paroxysmal disorders).

G40 Epilepsy and recurrent seizures (non-billable) G40.0 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset (non-billable) G40.00 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable (non-billable) G40.001 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus G40.009 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus G40.01 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable (non-billable) G40.011 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus G40.019 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus G40.1 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures (non-billable) G40.10 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable (non-billable) G40.101 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus G40.109 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus G40.11 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable (non-billable) G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus G40.2 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures (non-billable) G40.20 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable (non-billable) G40.201 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus G40.209 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus G40.21 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable (non-billable)

ICD-10 G43.41, Billing FAQ

Is ICD-10 code G43.41 billable? +

No, G43.41 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 G43.41? +

ICD-10 G43.41 includes: Hemiplegic migraine with refractory migraine.

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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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