Hemiplegic migraine, intractable, without status migrainosus

This code describes a severe form of migraine characterized by temporary weakness or paralysis on one side of the body (hemiplegia) during or after the headache phase. "Intractable" signifies that the migraine is resistant to standard treatments, and "without status migrainosus" indicates the attack does not last for an extended period (typically over 72 hours) or is not unremitting.

Use this code for patients diagnosed with hemiplegic migraine that has proven difficult to manage with conventional therapies. Documentation should clearly state the presence of transient hemiparesis/hemiplegia associated with the migraine, the intractable nature of the condition, and explicitly rule out status migrainosus.

• Ensure documentation specifies "intractable" and "without status migrainosus" to support this specific code.
• Distinguish from other migraine types; the key feature here is the hemiplegic aura.
• Do not confuse with G43.409 (not intractable) or G43.411 (with status migrainosus).