Anesthesia Coding Alert

A solid understanding helps clarify the choices.

The terms “with aura” and “without aura” appear often in ICD-10’s migraine descriptors—so it’s important to understand what “aura” means.

“The term aura when being used with a migraine are specific nervous system symptoms that occur or begin approximately five to 20 minutes prior to the onset of the headache,” says Yvonne Dillon, CPC, CEDC, manager of coding documentation at ZOTEC Partners in Carmel, Indiana. These symptoms can include the following:

• Blind spots within the patient’s visual field
• Seeing a “zigzag” pattern
• Blindness affecting half of the patient’s visual field in either both or one eye
• Visual hallucinations
• Seeing flashing lights
• Pins and needles sensation in arm or leg
• Difficulty speaking

When considering aura, “I look for notes indicating visual disturbances, like seeing patterns or lights or losing vision, tunnel vision, etc.,” explains Cathy Satkus, CPC, COBGC, of Harvard Family Physicians in Tulsa, Oklahoma.