InnovaRx Innova Health Strategies

G43.C1

Periodic headache syndromes in child or adult, intractable

Billable FY2026 2025-10-01 → 2026-09-30
Exclusions 11 never code together
G43code
Excludes1
  • headache NOS (R51.9)R51.9
  • lower half migraine (G44.00)G44.00
Excludes2
  • headache syndromes (G44.-)G44.-
G00-G99chapter
Excludes2
  • certain conditions originating in the perinatal period (P04-P96)P04-P96
  • certain infectious and parasitic diseases (A00-B99)A00-B99
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)O00-O9A
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Q00-Q99
  • endocrine, nutritional and metabolic diseases (E00-E88)E00-E88
  • injury, poisoning and certain other consequences of external causes (S00-T88)S00-T88
  • neoplasms (C00-D49)C00-D49
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)R00-R94

Excludes1 — never code together. The excluded condition and this one are mutually exclusive.

Excludes2 — not included here, but the patient may have both. Code both when documented.

Instructional notes 3
G43code
Notes
  • the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled
Use additional code
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)T36-T50
G43.C1code
Inclusion terms
  • Periodic headache syndromes in child or adult, with refractory migraine
Index entries leading here 1
  • Headache R51.9
    • periodic syndromes in adults and children G43.C0
Alongside this code 1 same parent — G43.C
Additional references
AHA Coding Clinic® Licence required

Official coding advice for this code. Published by the American Hospital Association. Not included in this installation.

Risk adjustment

RX08HCC166

Presence is a property of the code. Untick a model to hide it everywhere.

This code

Billable
yes
Code set
FY2026
Parent
G43.C
Block
G40-G47
Siblings
1

Present FY2024–FY2027.