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    OpenPayerBilling CodesGlomerular diseasesICD-10-CM n04-nephrotic-syndrome
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    ICD-10-CM Code For Nephrotic Syndrome: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group N04 includes nephrotic syndrome diagnoses such as minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and other glomerular disorders that present with heavy proteinuria and related complications. These ICD-10-CM diagnosis codes are used to document clinical scenarios involving significant protein loss, edema, hypoalbuminemia, and renal involvement that affect treatment decisions and monitoring. Accurate coding within the ICD-10-CM N04 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM N04: Nephrotic Syndrome Overview

    The ICD-10-CM N04 group represents nephrotic syndrome, a set of glomerular disorders characterized by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia that primarily affect the renal system. These diagnoses target glomerular disease processes leading to significant protein loss and fluid imbalance. Accurate coding matters for reimbursement because it reflects disease severity and complications that influence claim adjudication and clinical resource use.

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    When to Use

    Use a code from this group when a patient has clinical and laboratory evidence of nephrotic syndrome, including marked proteinuria and associated hypoalbuminemia or edema. Select the specific code when the underlying histologic diagnosis or secondary cause is documented to capture disease etiology and complexity.

    ICD-10-CM Codes

    16 rows

    ICD-10-CM CodeDescription
    N04.0Nephrotic syndrome with minor glomerular abnormality
    N04.1Nephrotic syndrome with focal and segmental glomerular lesions
    N04.20Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecified
    N04.21Primary membranous nephropathy with nephrotic syndrome
    N04.22Secondary membranous nephropathy with nephrotic syndrome
    N04.29Other nephrotic syndrome with diffuse membranous glomerulonephritis
    N04.3Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis
    N04.4Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritis
    N04.5Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis
    N04.6Nephrotic syndrome with dense deposit disease
    N04.7Nephrotic syndrome with diffuse crescentic glomerulonephritis
    N04.8Nephrotic syndrome with other morphologic changes
    N04.9Nephrotic syndrome with unspecified morphologic changes
    N04.ANephrotic syndrome with C3 glomerulonephritis
    N04.B1Nephrotic syndrome with idiopathic immune complex membranoproliferative glomerulonephritis (IC-MPGN)
    N04.B2Nephrotic syndrome with secondary immune complex membranoproliferative glomerulonephritis (IC-MPGN)

    DRG Codes

    3 rows

    DRG CodeDescription
    698Other Kidney and Urinary Tract Diagnoses with MCC
    699Other Kidney and Urinary Tract Diagnoses with CC
    700Other Kidney and Urinary Tract Diagnoses without CC/MCC

    Typical Clinical Scenarios

    • An adult patient with sudden onset of generalized edema, frothy urine, and rapid weight gain over days presents to the emergency department after laboratory tests show heavy proteinuria (>3.5 g/day), hypoalbuminemia, and hyperlipidemia. Workup reveals a presumed primary nephrotic syndrome without identified secondary cause, and the clinician documents nephrotic-range proteinuria requiring inpatient management for fluid status and diagnostic renal evaluation. Typical codes: N04.0, N04.9
    • A child or young adolescent followed in outpatient nephrology for chronic minimal change disease with persistent proteinuria despite maintenance therapy, with periodic relapses and monitoring of renal function and albumin. The encounter is for routine management of an ongoing glomerular disease causing recurrent nephrotic syndrome and assessment of treatment response and complications of long-term therapy. Typical codes: N04.1, N04.21
    • An adult with long-standing systemic lupus erythematosus develops worsening edema and laboratory evidence of nephrotic-range proteinuria; renal biopsy confirms lupus-associated nephrotic syndrome, and the visit focuses on treatment of the glomerular involvement as a complication of the systemic disease. Typical codes: N04.22, N04.29

    Related Codes

    N00-ACUTE-NEPHRITIC-SYNDROME

    ICD-10-CM Code For Acute Nephritic Syndrome: Group Overview

    N01-RAPIDLY-PROGRESSIVE-NEPHRITIC-SYNDROME

    ICD-10-CM Code For Rapidly Progressive Nephritic Syndrome: Group Overview

    N02-RECURRENT-AND-PERSISTENT-HEMATURIA

    ICD-10-CM Code For Recurrent And Persistent Hematuria: Group Overview

    N03-CHRONIC-NEPHRITIC-SYNDROME

    ICD-10-CM Code For Chronic Nephritic Syndrome: Group Overview

    N05-UNSPECIFIED-NEPHRITIC-SYNDROME

    ICD-10-CM Code For Unspecified Nephritic Syndrome: Group Overview

    N06-ISOLATED-PROTEINURIA-WITH-LESION

    ICD-10-CM Code For Isolated Proteinuria With Specified Morphological Lesion: Group Overview

    N07-HEREDITARY-NEPHROPATHY-NOT-ELSEWHERE-CLASSIFIED

    ICD-10-CM Code For Hereditary Nephropathy Not Elsewhere Classified: Group Overview

    N08-GLOMERULAR-DISORDERS-IN-DISEASES-CLASSIFIED-ELSEWHERE

    ICD-10-CM Code For Glomerular Disorders In Diseases Classified Elsewhere: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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