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G90.4 ICD-10-CM Code: Autonomic dysreflexia

ICD-10-CM Code View

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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Other disorders of the nervous system (G89-G99)

G90.4

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Autonomic dysreflexia

A sudden, dangerous spike in blood pressure and other symptoms triggered by stimuli below the level of spinal cord injury, commonly occurring in patients with high spinal cord injuries.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
G90Disorders of autonomic nervous system
G90.4Autonomic dysreflexia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G90.4 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G90.4 in this effective period.

Related Child Codes

Official
G90.0Idiopathic peripheral autonomic neuropathy
G90.1Familial dysautonomia [Riley-Day]
G90.2Horner's syndrome
G90.3Multi-system degeneration of the autonomic nervous system
G90.5Complex regional pain syndrome I (CRPS I)

Includes

Official

ICD-10-CM does not list Includes notes for G90.4 in this effective period.

Excludes 1

Official
  • dysfunction of the autonomic nervous system due to alcohol (G31.2)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G90.4 in this effective period.

Use Additional

Official
  • code to identify the cause, such as:
  • fecal impaction (K56.41)
  • pressure ulcer (pressure area) (L89.-)
  • urinary tract infection (N39.0)

Code Also

Official

ICD-10-CM does not list Code Also instructions for G90.4 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Always code the associated spinal cord injury when present
This is a medical emergency; document triggering factors and treatment response

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is G90.4 an HCC code?

No. G90.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

G90.4 is the ICD-10-CM diagnosis code for autonomic dysreflexia. A sudden, dangerous spike in blood pressure and other symptoms triggered by stimuli below the level of spinal cord injury, commonly occurring in patients with high spinal cord injuries. G90.4 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering other disorders of the nervous system (g89-g99).

G90.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Always code the associated spinal cord injury when present.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G90.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Always code the associated spinal cord injury when present
  • This is a medical emergency; document triggering factors and treatment response

Use Additional Code

  • code to identify the cause, such as:
  • fecal impaction (K56.41)
  • pressure ulcer (pressure area) (L89.-)
  • urinary tract infection (N39.0)

Child Codes

Code Hierarchy

Work G90.4 in HCC Buddy

Open G90.4 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 14 days to try everything.