What is the ICD-10 code for nephrotic syndrome?

The ICD-10 code for nephrotic syndrome with diffuse membranous glomerulonephritis is N04.2. It requires biopsy confirmation and documentation of nephrotic-range proteinuria.

How to document nephrotic syndrome for coding?

Document biopsy results, proteinuria levels, and specify primary or secondary etiology to ensure accurate coding of nephrotic syndrome.

ICD-10 Coding for Nephrotic Syndrome(N04.2, E78.5, N04.1)

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Comprehensive guide on ICD-10 coding for nephrotic syndrome, including documentation requirements, code relationships, and common pitfalls.

Also known as:

NephrosisNephrotic Range Proteinuria

Related ICD-10 Code Ranges

Complete code families applicable to Nephrotic Syndrome

N00-N99Primary Range

Diseases of the genitourinary system

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
N04.2	Nephrotic syndrome with diffuse membranous glomerulonephritis	Use when biopsy confirms diffuse membranous glomerulonephritis with nephrotic syndrome.	Biopsy confirmation of membranous glomerulonephritis Nephrotic-range proteinuria (≥3.5 g/day)
N04.21	Nephrotic syndrome with primary membranous nephropathy	Use when primary membranous nephropathy is confirmed by biopsy.	Biopsy confirmation of primary membranous nephropathy Nephrotic-range proteinuria (≥3.5 g/day)

Primary ICD-10-CM Codes

Nephrotic syndrome with diffuse membranous glomerulonephritis

N04.2

Differential Codes

Alternative codes to consider when ruling out similar conditions

Nephrotic syndrome with focal segmental glomerulosclerosisN04.1

Nephrotic syndrome with secondary membranous nephropathyN04.22

Documentation & Coding Risks

Avoid these common issues when documenting Nephrotic Syndrome.

Omitting biopsy results in documentation.

Impact

Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential reimbursement issues due to incorrect DRG assignment.

Mitigation

Ensure biopsy results are documented before coding., Train staff on the importance of complete documentation.

Misclassifying primary nephrotic syndrome as secondary.

Impact

Reimbursement: Incorrect DRG assignment may affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.

Mitigation

Verify biopsy results and document primary or secondary etiology clearly.

Biopsy Documentation

Impact

Lack of biopsy documentation can lead to incorrect coding.

Mitigation

Implement a checklist to ensure biopsy results are included in patient records.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with N04.2.

Focal Segmental Glomerulosclerosis→

Primary Code

N04.2

Nephrotic syndrome with diffuse membranous glomerulonephritis

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ICD-10 codes6

Coding risks3

FAQs2

ICD-10 Coding for Nephrotic Syndrome(N04.2, E78.5, N04.1)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for nephrotic syndrome?

How to document nephrotic syndrome for coding?

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