Facebook tracking pixel
G90.9
ICD-10-CM
Autonomic Dysfunction

Understanding Autonomic Dysfunction (Dysautonomia) diagnosis, symptoms, and treatment. Find information on Autonomic Neuropathy, clinical documentation tips for healthcare professionals, and medical coding guidelines for accurate billing. Learn about the latest research and resources for managing Autonomic Dysfunction.

Also known as

Dysautonomia
Autonomic Neuropathy

Diagnosis Snapshot

Key Facts
  • Definition : Problem with the autonomic nervous system, controlling involuntary body functions like heart rate, blood pressure, and digestion.
  • Clinical Signs : Dizziness, fainting, digestive issues, abnormal heart rate or blood pressure, bladder problems, sweating abnormalities.
  • Common Settings : Neurology, Cardiology, Gastroenterology, Primary Care

Related ICD-10 Code Ranges

Complete code families applicable to AAPC G90.9 Coding
G90.3

Other autonomic nervous system disorders

Covers various autonomic dysfunctions not specified elsewhere.

G62.9

Polyneuropathy, unspecified

Includes autonomic neuropathy if not specified further.

R06.89

Other specified abnormalities of heart beat

May be applicable for some autonomic dysfunction heart manifestations.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the autonomic dysfunction related to a primary disease?

  • Yes

    Specify the primary disease.

  • No

    Is the autonomic dysfunction idiopathic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Problem with the autonomic nervous system.
Postural Orthostatic Tachycardia Syndrome.
Neurocardiogenic Syncope (NCS).

Documentation Best Practices

Documentation Checklist
  • Document autonomic dysfunction symptoms (e.g., orthostatic hypotension, syncope)
  • Specify type of autonomic dysfunction (e.g., POTS, neurocardiogenic syncope)
  • Include diagnostic test results (e.g., tilt table test, autonomic reflex screen)
  • Note impact on daily activities (e.g., limitations, assistive devices)
  • Correlate symptoms with other conditions (e.g., diabetes, Parkinson's disease)

Coding and Audit Risks

Common Risks
  • Unspecified Dysautonomia

    Coding unspecified autonomic dysfunction (G90.9) when a more specific code exists based on clinical documentation. Impacts reimbursement and data accuracy.

  • Comorbidity Overlooked

    Failing to capture underlying conditions causing autonomic dysfunction (e.g., diabetes) leads to inaccurate risk adjustment and quality reporting.

  • Documentation Deficiency

    Insufficient clinical documentation to support the autonomic dysfunction diagnosis, impacting code assignment, audit validity, and compliance.

Mitigation Tips

Best Practices
  • ICD-10 G90.9, document orthostatic hypotension, sudomotor, GI symptoms
  • Regular exercise, hydration, compression stockings for blood pooling
  • Medication review: avoid exacerbating drugs, consider midodrine, fludrocortisone
  • Patient education: slow positional changes, avoid triggers like heat, alcohol
  • Monitor salt intake, small frequent meals for GI issues, consult specialists

Clinical Decision Support

Checklist
  • Review patient history for orthostatic hypotension, syncope, or POTS (ICD-10 G90.3)
  • Assess for sudomotor, cardiovascular, and gastrointestinal symptoms (SNOMED CT 234803000)
  • Check vital signs for abnormal heart rate and blood pressure responses
  • Consider tilt table test or other autonomic function tests for confirmation

Reimbursement and Quality Metrics

Impact Summary
  • Autonomic Dysfunction (Dysautonomia, Autonomic Neuropathy) reimbursement hinges on accurate ICD-10 coding (G90.8, G90.9, or specific manifestation codes) impacting hospital case mix index.
  • Coding specificity for Autonomic Dysfunction subtypes (e.g., Postural Orthostatic Tachycardia Syndrome) affects payment and quality reporting metrics.
  • Precise documentation of Autonomic Dysfunction symptoms is crucial for appropriate medical billing and justifies higher level Evaluation and Management codes.
  • Misdiagnosis or undercoding of Autonomic Dysfunction can lead to claim denials, impacting hospital revenue cycle management and quality data.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective diagnostic tests for confirming autonomic dysfunction in patients presenting with complex symptoms?

A: Diagnosing autonomic dysfunction (also known as dysautonomia or autonomic neuropathy) often requires a combination of tests due to the diverse nature of its presentation. Some of the most effective tests include quantitative sudomotor axon reflex testing (QSART) to assess sweat gland function, cardiovascular autonomic reflex tests (CARTs) like the Valsalva maneuver and head-up tilt table test to evaluate heart rate and blood pressure responses, and thermoregulatory sweat testing (TST) to map sweat patterns. Additional tests may be necessary depending on the specific symptoms. Explore how a comprehensive assessment combining these tests can pinpoint the underlying cause and severity of autonomic dysfunction, facilitating targeted treatment strategies. Consider implementing standardized protocols for autonomic testing to ensure consistency and accuracy in your clinical practice.

Q: How can I differentiate between autonomic dysfunction subtypes (e.g., postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope) in my clinical practice?

A: Differentiating between autonomic dysfunction subtypes like postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, and multiple system atrophy (MSA) requires careful evaluation of the patient's symptoms, medical history, and targeted diagnostic testing. POTS is characterized by a sustained increase in heart rate upon standing without significant hypotension, while neurocardiogenic syncope involves a sudden drop in blood pressure and heart rate leading to fainting. MSA presents with more widespread neurological symptoms, including parkinsonism and cerebellar dysfunction, in addition to autonomic issues. Head-up tilt table testing, along with detailed neurological examination and assessment of other symptoms, can help distinguish between these conditions. Learn more about the specific diagnostic criteria for each subtype to improve accuracy in diagnosis and tailor management approaches accordingly.

Quick Tips

Practical Coding Tips
  • Code G90.8 for unspecified autonomic dysfunction
  • Document specific symptoms for dysautonomia coding
  • Consider R59.0 for syncope in neuropathy
  • Check for orthostatic hypotension (I95.1)
  • Review documentation for secondary causes

Documentation Templates

Patient presents with symptoms suggestive of autonomic dysfunction, also known as dysautonomia or autonomic neuropathy.  Clinical presentation includes orthostatic hypotension, evidenced by a drop in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg within three minutes of standing, accompanied by symptoms such as dizziness, lightheadedness, and presyncope.  Additional symptoms reported include heat intolerance, gastrointestinal issues such as constipation and gastroparesis, and bladder dysfunction manifesting as urinary frequency or incontinence.  Neurological examination reveals abnormal sudomotor function, assessed via quantitative sudomotor axon reflex test (QSART), and cardiovascular autonomic testing demonstrates impaired baroreflex sensitivity.  Differential diagnosis includes other causes of orthostatic intolerance, such as volume depletion, medication side effects, and endocrine disorders.  Assessment for underlying conditions such as diabetes, Parkinson's disease, and autoimmune diseases is ongoing.  Plan includes patient education regarding lifestyle modifications, including increased fluid and salt intake, compression stockings, and avoiding prolonged standing.  Pharmacological interventions may be considered, including fludrocortisone and midodrine, to manage orthostatic hypotension.  Referral to a neurologist specializing in autonomic disorders is recommended for further evaluation and management.  ICD-10 code G90.9 (Disorder of autonomic nervous system, unspecified) is documented for medical billing and coding purposes.  Follow-up is scheduled to monitor symptom control and assess treatment efficacy.
Autonomic Dysfunction - AI-Powered ICD-10 Documentation