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Best Coding Practices: Migraines

Highmark·PA, NY, DE, WV · Neurology, Pain Management, General Practice +2 more·Coding
Effective date
Jul 22, 2026
We identified it
Jul 23, 2026
Days to comply

Summary

Highmark has published updated best coding practices for migraine diagnosis and treatment, emphasizing the use of ICD-10 codes from category G43 to accurately characterize migraine type and reflect disease burden. Providers should reference the updated Coding Education resources on the Provider Resource Center for comprehensive coding guidance and video presentations.

Action Required

Action needed
By August 22, 2026: Billing and coding staff should review the updated migraine coding guidance on Highmark's Provider Resource Center and ensure all migraine claims utilize appropriate ICD-10 codes from category G43 with proper type specification. Providers should be reminded to document specific migraine characteristics (type, aura presence, status migrainosus, etc.) to support accurate coding. Update internal coding reference materials and consider training staff on the new best practices, particularly for high-volume migraine cases. Access the Coding Education HCC University resource (authentication via Availity required) for detailed guidance and video training materials.

Affected Billing Codes

G43