N04 — Nephrotic syndrome
Is N04 billable?
No — N04 is a non-billable header code. N04 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 16 billable codes beneath N04.
Billable codes under this header
- N04.0Nephrotic syndrome with minor glomerular abnormality
- N04.1Nephrotic syndrome with focal and segmental glomerular lesions
- 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
- N04.20Nephrotic 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.B1Nephrotic syndrome with idiopathic immune complex membranoproliferative glomerulonephritis (IC-MPGN)
- N04.B2Nephrotic syndrome with secondary immune complex membranoproliferative glomerulonephritis (IC-MPGN)
N04 at a glance
| Code | N04 |
|---|---|
| Description | Nephrotic syndrome |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Includes
Conditions classified to N04.
- congenital nephrotic syndrome
- lipoid nephrosis
Excludes1 — never code together — inherited from N00-N08
The conditions below can never be reported together with N04 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- hypertensive chronic kidney disease (I12.-)
Excludes2 — not included here — inherited from Chapter 14
The conditions below are not part of N04, but a patient may have both at the same time. When documentation supports it, N04 and the excluded code may both be reported.
- 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)
Code also — inherited from N00-N08
Two codes may be needed to describe the condition fully. Whether N04 is sequenced first depends on the reason for the encounter.
- any associated kidney failure (N17-N19).
What codes fall under N04? (12)
- N04.0Nephrotic syndrome with minor glomerular abnormality
- N04.1Nephrotic syndrome with focal and segmental glomerular lesions
- N04.2Nephrotic syndrome with diffuse membranous glomerulonephritisnot billable
- 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.BNephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)not billable
How long has N04 existed?
N04 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.