G43.B1 — Ophthalmoplegic migraine, intractable
G43.B1 is a billable, specific ICD-10-CM code for ophthalmoplegic migraine, intractable. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Ophthalmoplegic migraine, with refractory migraine
Risk adjustment
G43.B1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
G43.B1 is named in 22 Medicare coverage policies — 22 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A55530Billing and Coding: Peripheral Nerve Stimulation
- A56273Billing and Coding: Chiropractic Services
- A56551Billing and Coding: Visual Fields Testing
How G43.B1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G43.B1.
- Migraine›ophthalmoplegic›intractable
- Migraine›ophthalmoplegic›with refractory migraine
Related codes at this level
Codes that share G43.B. If G43.B1 is not quite right, the correct code is usually one of these.
Questions about G43.B1
- Is G43.B1 a billable ICD-10-CM code?
- Yes. G43.B1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G43.B1 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).