`G43.B1` Ophthalmoplegic migraine, intractable

Billable ICD-10-CM code, FY2026.

Applicable to

Ophthalmoplegic migraine, with refractory migraine

Applies from G43 Migraine

Excludes1 (never code together)

headache NOS (R51.9)
lower half migraine (G44.00)

Excludes2 (not included here)

headache syndromes (G44.-)

Use additional code

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Notes

the following terms are to be considered equivalent to intractable: pharmacoresistant (pharmacologically resistant), treatment resistant, refractory (medically) and poorly controlled

Risk adjustment (HCC)

RxHCC V08: HCC 166 — Migraine Headaches

MS-DRG index

Defines the logic of DRG(s) 102-103 in MDC 01.

Approximate ICD-9-CM (GEMs)

346.21 Variants of migraine, not elsewhere classified, with intractable migraine, so stated, without mention of status migrainosus (approximate)

Code annotations containing back-references to G43.B1

Back-references to G43

Type 2 Excludes: G44 Other headache syndromes ("migraines (G43.-)")
Type 2 Excludes: G44.1 Vascular headache, not elsewhere classified ("migraine (G43.-)")
Type 2 Excludes: G89 Pain, not elsewhere classified ("migraines (G43.-)")
Type 2 Excludes: R51 Headache ("migraine and other headache syndromes (G43-G44)")

Diagnosis Index entries for G43.B1

Migraine (idiopathic) › ophthalmoplegic › with refractory migraine
Migraine (idiopathic) › ophthalmoplegic › intractable

Nearby codes

G43.A Cyclical vomiting
G43.A0 Cyclical vomiting, in migraine, not intractable
G43.A1 Cyclical vomiting, in migraine, intractable
G43.B Ophthalmoplegic migraine
G43.B0 Ophthalmoplegic migraine, not intractable
G43.B1 Ophthalmoplegic migraine, intractable (this code)
G43.C Periodic headache syndromes in child or adult
G43.C0 Periodic headache syndromes in child or adult, not intractable
G43.C1 Periodic headache syndromes in child or adult, intractable
G43.D Abdominal migraine
G43.D0 Abdominal migraine, not intractable