Skip to main content
Call AIBook a demo

ICD-10-CM G43.609: Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus

G43.609 is the billable ICD-10-CM code for persistent migraine aura with cerebral infarction, not intractable, without status migrainosus, in category G43 (Migraine) of the Episodic and paroxysmal disorders section. As a principal diagnosis it groups to MS-DRG 102 Headaches with MCC, MS-DRG 103 Headaches without MCC (MDC 01 MDC 01: Diseases and Disorders of the Nervous System). As a secondary diagnosis it is a CC, excluded with 121 principal diagnoses. 14 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
G43.609
billable FY2027 ICD-10-CM code
Category
G43 Migraine
Chapter
6: Diseases of the nervous system (G00-G99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
Not mapped
POA reporting
Required

Tabular list notes for G43.609

The tabular list has no notes on G43.609 itself; the notes below apply from its parent headings.

Inherited from G43 (Migraine)

Excludes1 (never coded together)
  • lower half migraine (G44.00)
Excludes2 (not part of this condition, may be coded together)
  • headache NOS (R51.9)
  • 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

Inherited from G43.6 (Persistent migraine aura with cerebral infarction)

Code also
  • the type of cerebral infarction (I63.-)

Inherited from G43.60 (Persistent migraine aura with cerebral infarction, not intractable)

Inclusion terms
  • Persistent migraine aura with cerebral infarction, without refractory migraine

MS-DRG grouping when G43.609 is the principal diagnosis

MS-DRG v44 groups for G43.609 as principal diagnosis
MDCMS-DRGs
01 MDC 01: Diseases and Disorders of the Nervous System102103

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for G43.609 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, G43.609 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 121 codes in its exclusion list. Check G43.609 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

G43.609 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

LCD billing and coding articles that list G43.609

14 current Medicare billing and coding articles list G43.609 among the diagnoses that support medical necessity for the services they cover.

For teams evaluating QuickIntell software

Evaluate software for diagnosis coding review

If your team codes diagnoses at volume, review how QuickCode supports qualified coder review of documentation, specificity queries and the billing handoff. Confirm the code sets, settings and reviewer responsibilities during evaluation; a code reference is not a coding determination for a patient.

Evaluate QuickCode for diagnosis codingSee risk adjustment review
Book a software demoAsk about a software workflow

Optional software evaluation, not payer support or help with an individual claim. For coverage or payment decisions, use the official sources on this page. Do not include patient information in a demo booking or inquiry.

Frequently asked questions

What does ICD-10-CM G43.609 mean?

G43.609 means persistent migraine aura with cerebral infarction, not intractable, without status migrainosus. It is one of 25 billable codes under G43, migraine.

Which MS-DRG does G43.609 group to?

As the principal diagnosis, G43.609 groups to MS-DRG 102 Headaches with MCC, MS-DRG 103 Headaches without MCC (MDC 01 MDC 01: Diseases and Disorders of the Nervous System) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Is G43.609 a CC or MCC?

G43.609 is a CC under MS-DRG v44; 121 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.