G90.3

HCC Category Mapping

What This Code Means

A progressive neurological disorder where multiple body systems controlled by the autonomic nervous system gradually deteriorate, affecting blood pressure, movement, and other vital functions.

Coding Tips

• •Document specific systems affected (cardiovascular, gastrointestinal, etc.) for complete coding
• •This is a degenerative condition; note progression and functional decline in documentation

Clinical Significance

Multi-system degeneration of the autonomic nervous system (also known as Shy-Drager syndrome or multiple system atrophy with autonomic predominance) is a progressive neurodegenerative disorder causing severe autonomic failure. This condition carries significant mortality and morbidity, with patients requiring intensive management for orthostatic hypotension, urinary dysfunction, and eventual respiratory compromise. It is a key risk-adjusting diagnosis given the high resource utilization and poor prognosis.

Documentation Requirements

• ✓Clinical findings of progressive autonomic failure (severe orthostatic hypotension, urinary retention/incontinence, anhidrosis)
• ✓Neurological examination documenting cerebellar or parkinsonian features if present
• ✓Imaging or diagnostic workup supporting multi-system atrophy diagnosis
• ✓Functional status assessment and degree of disability
• ✓Current treatment plan addressing autonomic symptoms (e.g., midodrine, fludrocortisone, compression garments)

Commonly Confused Codes