Boost Your Migraine Treatment

Smarts
Boost Your Migraine Treatment Smarts

Chris Boucher
CPC
Boost Your Migraine Treatment Smarts

Acute episodes, Check-ups are

both routine for patients with
Migraine.
Boost Your Migraine Treatment Smarts

ICD-9 codes usually

dominate when it comes
to Migraine headache
coding.
Boost Your Migraine Treatment Smarts

But also keep in mind to look for the

procedure codes attached to the complicated
migraine diagnoses.
Boost Your Migraine Treatment Smarts

Consider the following three scenarios

to help you code better
Boost Your Migraine Treatment Smarts

Scenario 1:

An established patient report to the FPP with

symptoms and end-up requiring treatment for an
acute migraine headache.
Boost Your Migraine Treatment Smarts

After diagnosing “migraine headache

w/o aura, HTN”, the physician then
injects 10mg of imitrex via injection.
Boost Your Migraine Treatment Smarts

How you will code:

• 96372  injection J3030 x2 for imitrex supply

• 99213  E/M
• Modifier 25 appended to 99213 (E/M and injection were
separate)
• 346.10 appended to 99213, 96372 and J3030 (to represent
migraine)
• 401.X appended to 99213 (to reflect comorbid condition)
Boost Your Migraine Treatment Smarts

Scenario: 2 (Consider plan of care in E/M)

A patient with a migraine diagnosis might report to the FP

for:

• diagnosis management
• medication management
• evaluation of efficacy of plan of care
• assessment of side effects associated with current
treatment plan.
Boost Your Migraine Treatment Smarts

Apply the appropriate E/M code or other CPT code[s]

when the physician or non-physician practitioner
(NPP) treats migraine patients for any of the reasons
mentioned.
Boost Your Migraine Treatment Smarts

Example:

An established patient with a plan of care reports to

the FP for ‘medication management’ and reports
“everything is fine”
Boost Your Migraine Treatment Smarts

For this condition-management E/M, you’d report

99212 with 346.00 appended, to represent the patient’s
migraines.
Boost Your Migraine Treatment Smarts

Scenario: 3

A patient with a plan of care might also have an acute

migraine that requires FP intervention.

You’ll report an E/M or injection - or both,

depending on the situation
Boost Your Migraine Treatment Smarts

Example:

An established female patient presents having an acute

menstrual migraine.

The FP injects the patient with 6 mg of Imitrex and 1

unit of Compazine
Boost Your Migraine Treatment Smarts

How you will code:

• 96372 x 2 for the injections
• J3030 for the Imitrex supply
• J0780 for the Compazine supply
• 99214 with modifier 25 to show that the E/M and
injections were separate services
• 346.40 appended to 96372, J3030, J0780, and 99214 to
represent the patient’s condition
Boost Your Migraine Treatment Smarts

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