ICD-10 Coding for Dysautonomia(G90.A, G90.1)
Complete ICD-10-CM coding and documentation guide for Dysautonomia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Dysautonomia
G90Primary Range
Disorders of autonomic nervous system
This range includes primary codes for various forms of dysautonomia, including POTS and familial dysautonomia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G90.A | Postural orthostatic tachycardia syndrome (POTS) | Use when POTS is diagnosed with documented criteria and no secondary causes. |
|
| G90.1 | Familial dysautonomia (Riley-Day syndrome) | Use when familial dysautonomia is confirmed by genetic testing. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for POTS
Essential facts and insights about Dysautonomia
Primary ICD-10-CM Codes for dysautonomia
Decision Criteria
clinical Criteria
- HR increase ≥30 bpm on tilt test
documentation Criteria
- Exclusion of secondary causes
Applicable To
- POTS
Excludes
- Familial dysautonomia (G90.1)
Clinical Validation Requirements
- Tilt table test showing HR increase ≥30 bpm (≥40 bpm for ages 12-19) within 10 minutes of standing
- Absence of orthostatic hypotension
- Exclusion of secondary causes such as anemia or hyperthyroidism
Code-Specific Risks
- Incorrectly coding as G90.1
- Lack of documentation for tilt test results
Coding Notes
- Ensure documentation of HR increase and exclusion of secondary causes.
G90.1 - Familial dysautonomia (Riley-Day syndrome)
Use when familial dysautonomia is confirmed by genetic testing.
Applicable To
- Riley-Day syndrome
Excludes
- POTS (G90.A)
Clinical Validation Requirements
- Genetic testing confirming IKBKAP mutation
- Symptoms of autonomic failure such as blood pressure instability
Coding Notes
Document genetic confirmation and specific symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Dysautonomia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G90.A.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use specific criteria for POTS documentation., Ensure exclusion of secondary causes is documented.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify the specific type of dysautonomia and use G90.A for POTS.
Impact
Lack of specific documentation for HR increase and exclusion of secondary causes.
Mitigation Strategy
Ensure all criteria are documented in patient records.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Dysautonomia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Dysautonomia
Use these documentation templates to ensure complete and accurate documentation for Dysautonomia. These templates include all required elements for proper coding and billing.
POTS Diagnosis
Specialty: NeurologyRequired Elements
- Orthostatic vitals
- Tilt table test results
- Exclusion of secondary causes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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