AI Scribe for
Migraine

Migraine is not a single entity — it is a spectrum of disorders with distinct phenotypes (migraine with aura, migraine without aura, chronic migraine, hemiplegic migraine, vestibular migraine) that require precise characterization to guide treatment and support coding.

For patients with chronic migraine (≥15 headache days per month with ≥8 meeting migraine criteria), the documentation must establish chronicity, track headache diary data, and support medical necessity for preventive treatments — including CGRP monoclonal antibodies, which require prior authorization with documented failure of ≥2 prior preventive medication classes.

An AI scribe without migraine-specific training will capture headache complaints but will not structure the documentation to support the classification, the disability assessment, or the prior authorization requirements that chronic migraine care involves.

For an initial migraine evaluation: headache phenotype including location, quality, severity, and duration; presence and character of aura with onset and duration; associated symptoms (nausea, vomiting, photophobia, phonophobia, osmophobia); functional impact and disability (MIDAS or HIT-6 score where applicable); identified triggers; prior acute and preventive medication history with efficacy, dosing, and reasons for discontinuation; and family history of migraine.

For follow-up visits: headache diary data (headache days per month, severe days, acute medication use days); response to current preventive therapy with tolerability; any new symptoms or change in headache character that might suggest secondary etiology; and updated medication list.

The structured recording of headache days per month and acute medication use days is particularly important for patients approaching or meeting chronic migraine criteria — it directly supports prior authorization for advanced preventive therapies.

CGRP monoclonal antibodies — erenumab, fremanezumab, galcanezumab, and eptinezumab — are the most significant advance in migraine prevention in decades. They also require prior authorization from most payers, with documentation requirements that vary by payer but typically include: diagnosis of episodic or chronic migraine, baseline headache frequency, and documented failure of at least two prior preventive medication classes.

When a practice's documentation has not systematically captured prior preventive therapy trials — what was tried, at what doses, for how long, and why it was discontinued — building a prior authorization package requires reconstructing information from fragmented records. This delays patient care and increases administrative burden.

Scryber's documentation workflow captures preventive medication history as a structured element of every migraine visit, making prior authorization documentation a byproduct of good clinical documentation rather than a separate administrative task.