2020 ICD-10-CM Diagnosis Code G90.4

Autonomic dysreflexia

    2016 2017 2018 2019 2020 Billable/Specific Code
  • G90.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2020 edition of ICD-10-CM G90.4 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of G90.4 - other international versions of ICD-10 G90.4 may differ.
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Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code to identify the cause, such as:
  • fecal impaction (
    ICD-10-CM Diagnosis Code K56.41

    Fecal impaction

      2016 2017 2018 2019 2020 Billable/Specific Code
    Type 1 Excludes
    K56.41
    )
  • pressure ulcer (pressure area) (
    ICD-10-CM Diagnosis Code L89
    • L89 Pressure ulcer
      • L89.0 Pressure ulcer of elbow
        • L89.00 Pressure ulcer of unspecified elbow
          • L89.000 Pressure ulcer of unspecified elbow, unstagea...
          • L89.001 …… stage 1
          • L89.002 …… stage 2
          • L89.003 …… stage 3
          • L89.004 …… stage 4
          • L89.006 Pressure-induced deep tissue damage of unspec...
          • L89.009 Pressure ulcer of unspecified elbow, unspecif...
        • L89.01 Pressure ulcer of right elbow
        • L89.02 Pressure ulcer of left elbow
      • L89.1 Pressure ulcer of back
        • L89.10 Pressure ulcer of unspecified part of back
          • L89.100 Pressure ulcer of unspecified part of back, u...
          • L89.101 Pressure ulcer of unspecified part of back, s...
          • L89.102 Pressure ulcer of unspecified part of back, s...
          • L89.103 Pressure ulcer of unspecified part of back, s...
          • L89.104 Pressure ulcer of unspecified part of back, s...
          • L89.106 Pressure-induced deep tissue damage of unspec...
          • L89.109 Pressure ulcer of unspecified part of back, u...
        • L89.11 Pressure ulcer of right upper back
          • L89.110 Pressure ulcer of right upper back, unstageab...
          • L89.111 …… stage 1
          • L89.112 …… stage 2
          • L89.113 …… stage 3
          • L89.114 …… stage 4
          • L89.116 Pressure-induced deep tissue damage of right ...
          • L89.119 Pressure ulcer of right upper back, unspecifi...
        • L89.12 Pressure ulcer of left upper back
          • L89.120 Pressure ulcer of left upper back, unstageabl...
          • L89.121 …… stage 1
          • L89.122 …… stage 2
          • L89.123 …… stage 3
          • L89.124 …… stage 4
          • L89.126 Pressure-induced deep tissue damage of left u...
          • L89.129 Pressure ulcer of left upper back, unspecifie...
        • L89.13 Pressure ulcer of right lower back
          • L89.130 Pressure ulcer of right lower back, unstageab...
          • L89.131 …… stage 1
          • L89.132 …… stage 2
          • L89.133 …… stage 3
          • L89.134 …… stage 4
          • L89.136 Pressure-induced deep tissue damage of right ...
          • L89.139 Pressure ulcer of right lower back, unspecifi...
        • L89.14 Pressure ulcer of left lower back
          • L89.140 Pressure ulcer of left lower back, unstageabl...
          • L89.141 …… stage 1
          • L89.142 …… stage 2
          • L89.143 …… stage 3
          • L89.144 …… stage 4
          • L89.146 Pressure-induced deep tissue damage of left l...
          • L89.149 Pressure ulcer of left lower back, unspecifie...
        • L89.15 Pressure ulcer of sacral region
      • L89.2 Pressure ulcer of hip
        • L89.20 Pressure ulcer of unspecified hip
          • L89.200 Pressure ulcer of unspecified hip, unstageabl...
          • L89.201 …… stage 1
          • L89.202 …… stage 2
          • L89.203 …… stage 3
          • L89.204 …… stage 4
          • L89.206 Pressure-induced deep tissue damage of unspec...
          • L89.209 Pressure ulcer of unspecified hip, unspecifie...
        • L89.21 Pressure ulcer of right hip
        • L89.22 Pressure ulcer of left hip
      • L89.3 Pressure ulcer of buttock
        • L89.30 Pressure ulcer of unspecified buttock
          • L89.300 Pressure ulcer of unspecified buttock, unstag...
          • L89.301 Pressure ulcer of unspecified buttock, stage ...
          • L89.302 Pressure ulcer of unspecified buttock, stage ...
          • L89.303 Pressure ulcer of unspecified buttock, stage ...
          • L89.304 Pressure ulcer of unspecified buttock, stage ...
          • L89.306 Pressure-induced deep tissue damage of unspec...
          • L89.309 Pressure ulcer of unspecified buttock, unspec...
        • L89.31 Pressure ulcer of right buttock
        • L89.32 Pressure ulcer of left buttock
      • L89.4 Pressure ulcer of contiguous site of back, bu...
        • L89.40 Pressure ulcer of contiguous site of back, bu...
        • L89.41 Pressure ulcer of contiguous site of back, bu...
        • L89.42 Pressure ulcer of contiguous site of back, bu...
        • L89.43 Pressure ulcer of contiguous site of back, bu...
        • L89.44 Pressure ulcer of contiguous site of back, bu...
        • L89.45 Pressure ulcer of contiguous site of back, bu...
        • L89.46 Pressure-induced deep tissue damage of contig...
      • L89.5 Pressure ulcer of ankle
        • L89.50 Pressure ulcer of unspecified ankle
          • L89.500 Pressure ulcer of unspecified ankle, unstagea...
          • L89.501 …… stage 1
          • L89.502 …… stage 2
          • L89.503 …… stage 3
          • L89.504 …… stage 4
          • L89.506 Pressure-induced deep tissue damage of unspec...
          • L89.509 Pressure ulcer of unspecified ankle, unspecif...
        • L89.51 Pressure ulcer of right ankle
        • L89.52 Pressure ulcer of left ankle
      • L89.6 Pressure ulcer of heel
        • L89.60 Pressure ulcer of unspecified heel
          • L89.600 Pressure ulcer of unspecified heel, unstageab...
          • L89.601 …… stage 1
          • L89.602 …… stage 2
          • L89.603 …… stage 3
          • L89.604 …… stage 4
          • L89.606 Pressure-induced deep tissue damage of unspec...
          • L89.609 Pressure ulcer of unspecified heel, unspecifi...
        • L89.61 Pressure ulcer of right heel
        • L89.62 Pressure ulcer of left heel
      • L89.8 Pressure ulcer of other site
      • L89.9 Pressure ulcer of unspecified site
        • L89.90 Pressure ulcer of unspecified site, unspecifi...
        • L89.91 …… stage 1
        • L89.92 …… stage 2
        • L89.93 …… stage 3
        • L89.94 …… stage 4
        • L89.95 Pressure ulcer of unspecified site, unstageab...
        • L89.96 Pressure-induced deep tissue damage of unspec...
    L89.-
    )
  • urinary tract infection (
    ICD-10-CM Diagnosis Code N39.0

    Urinary tract infection, site not specified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Type 1 Excludes
    • candidiasis of urinary tract (B37.4-)
    • neonatal urinary tract infection (P39.3)
    • pyuria (R82.81)
    • urinary tract infection of specified site, such as:
    • cystitis (N30.-)
    • urethritis (N34.-)
    Use Additional
    • code (B95-B97), to identify infectious agent.
    N39.0
    )
The following code(s) above G90.4 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to G90.4:
  • G00-G99
    2020 ICD-10-CM Range G00-G99

    Diseases of the nervous system

    Type 2 Excludes
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    Diseases of the nervous system
  • G90
    ICD-10-CM Diagnosis Code G90

    Disorders of autonomic nervous system

      2016 2017 2018 2019 2020 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • dysfunction of the autonomic nervous system due to alcohol (G31.2)
    Disorders of autonomic nervous system
Clinical Information
  • A syndrome associated with damage to the spinal cord above the mid thoracic level (see spinal cord injuries) characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention. Manifestations include hypertension; tachycardia (or reflex bradycardia); fever; flushing; and hyperhidrosis. Extreme hypertension may be associated with a stroke. (from Adams et al., Principles of Neurology, 6th ed, pp538 and 1232; j spinal cord med 1997;20(3):355-60)
  • Life threatening inhibited sympathetic response to a noxious stimuli in a person with a spinal cord injury at t7 or above
  • Life-threatening, uninhibited sympathetic response of the nervous system to a noxious stimulus after a spinal cord injury at t7 or above
ICD-10-CM G90.4 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 073 Cranial and peripheral nerve disorders with mcc
  • 074 Cranial and peripheral nerve disorders without mcc

Convert G90.4 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change

Diagnosis Index entries containing back-references to G90.4:
  • Dysreflexia, autonomic G90.4

ICD-10-CM Codes Adjacent To G90.4
G89.29 Other chronic pain
G89.3 Neoplasm related pain (acute) (chronic)
G89.4 Chronic pain syndrome
G90 Disorders of autonomic nervous system
G90.0 Idiopathic peripheral autonomic neuropathy
G90.01 Carotid sinus syncope
G90.09 Other idiopathic peripheral autonomic neuropathy
G90.1 Familial dysautonomia [Riley-Day]
G90.2 Horner's syndrome
G90.3 Multi-system degeneration of the autonomic nervous system
G90.4 Autonomic dysreflexia
G90.5 Complex regional pain syndrome I (CRPS I)
G90.50 Complex regional pain syndrome I, unspecified
G90.51 Complex regional pain syndrome I of upper limb
G90.511 Complex regional pain syndrome I of right upper limb
G90.512 Complex regional pain syndrome I of left upper limb
G90.513 …… bilateral
G90.519 Complex regional pain syndrome I of unspecified upper limb
G90.52 Complex regional pain syndrome I of lower limb
G90.521 Complex regional pain syndrome I of right lower limb
G90.522 Complex regional pain syndrome I of left lower limb

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.