ICD-10 G43.C1
Billable / SpecificPeriodic headache syndromes in child or adult, intractable
About ICD-10-CM G43.C1
ICD-10-CM code G43.C1 represents Periodic headache syndromes in child or adult, intractable. This is a billable/specific code in the Nervous System chapter (block G43). The 2026 edition of ICD-10-CM G43.C1 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under G43.C1. Per CMS ICD-10-CM Tabular 2026.
- Periodic headache syndromes in child or adult, with refractory migraine
Medicare LCD Coverage for G43.C1
Local Coverage Determinations (LCDs) from CMS MACs that list G43.C1 as a covered diagnosis.
Showing top 10 of 465 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G43.C1.
5 Medicare
CPT Codes Commonly Billed with G43.C1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 46505 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 64647 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 43201 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 64645 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 43236 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- J0589 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 64612 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 64642 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- J0587 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
- 64643 CMS LCD: Billing and Coding: Botulinum Toxin Injections CMS LCD
Convert G43.C1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| G43.C1 | 34621 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To G43.C1
Other codes in section G40-G47 (Episodic and paroxysmal disorders).
ICD-10 G43.C1, Billing FAQ
Is ICD-10 code G43.C1 billable? +
Yes, G43.C1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to G43.C1? +
ICD-10 G43.C1 includes: Periodic headache syndromes in child or adult, with refractory migraine.
What CPT codes are commonly billed with G43.C1? +
Procedures frequently paired with G43.C1 include: 46505, 64647, 43201, 64645, 43236.
What ICD-9 codes does G43.C1 map to? +
Per CMS GEMs, G43.C1 maps to ICD-9 codes: 34621. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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