Question: During an office evaluation and management (E/M) service for an established patient, the physician diagnoses Shy-Drager syndrome. The E/M included moderate-level medical decision making (MDM) and lasted 34 minutes. How should I report this encounter? I’m a little unclear on what Shy-Drager syndrome is, or how to choose a diagnosis code for the condition. Idaho Subscriber Answer: First, the coding; then some diagnostic explanation. On the claim, report: Shy-Drager explained: The reason you had trouble finding an ICD-10 code might have something to do with the term Shy-Drager syndrome, which is a bit dated. The current correct term for Shy-Drager syndrome is multiple system atrophy (MSA), which translates to G90.3. According to Mayo Clinic, this “is a rare, degenerative neurological disorder affecting your body’s involuntary (autonomic) functions, including blood pressure, and motor control. MSA was formerly called Shy-Drager syndrome, olivopontocerebellar atrophy, or striatonigral degeneration.”