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ICD-10 Guide
ICD-10 CodesN02.1

N02.1

Billable

Recurrent and persistent hematuria with focal and segmental glomerular lesions

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N02.1 is a billable code used to indicate a diagnosis of recurrent and persistent hematuria with focal and segmental glomerular lesions.

Key Diagnostic Point:

N02.1 refers to a condition characterized by recurrent and persistent hematuria, which is the presence of blood in the urine, associated with focal and segmental glomerular lesions. This condition often indicates underlying glomerular disease, such as glomerulonephritis or nephritis, where inflammation and damage to the glomeruli lead to proteinuria (excess protein in urine) and hematuria. Patients may present with symptoms such as edema, hypertension, and renal impairment. A renal biopsy is typically performed to confirm the diagnosis and assess the extent of glomerular damage. Management may include corticosteroids, immunosuppressants, and supportive care, depending on the underlying cause and severity of the lesions. Regular monitoring of renal function and urine analysis is essential to evaluate disease progression and treatment efficacy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between types of glomerular lesions
  • Need for renal biopsy results for accurate coding
  • Variability in clinical presentation and underlying causes
  • Potential for co-existing renal conditions

Audit Risk Factors

  • Insufficient documentation of hematuria episodes
  • Lack of renal biopsy results in the medical record
  • Inconsistent coding of related renal conditions
  • Failure to document the clinical rationale for treatment

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical notes on hematuria episodes, renal function tests, and biopsy results.

Common Clinical Scenarios

Patients presenting with unexplained hematuria, proteinuria, or renal impairment.

Billing Considerations

Ensure that all relevant laboratory results and imaging studies are included in the documentation.

Pathology

Documentation Requirements

Comprehensive pathology reports detailing glomerular lesions and any associated findings.

Common Clinical Scenarios

Biopsy specimens from patients with suspected glomerular disease.

Billing Considerations

Pathology reports should clearly indicate the type of lesions and their clinical significance.

Coding Guidelines

Inclusion Criteria

Use N02.1 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the patient's clinical presentation, diagnostic tests, and treatment plans
  • Include specific details about the nature of hematuria and any associated renal conditions

Exclusion Criteria

Do NOT use N02.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

Renal biopsy CPT codeCPT Code

Renal biopsy

Clinical Scenario

When a renal biopsy is performed to assess the cause of hematuria and glomerular lesions.

Documentation Requirements

Biopsy report must detail the findings and correlate with clinical symptoms.

Specialty Considerations

Nephrologists should ensure that the biopsy is justified based on clinical indications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of renal conditions, improving the ability to capture the nuances of glomerular diseases like N02.1. This specificity aids in better tracking of disease prevalence and management outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of renal conditions, improving the ability to capture the nuances of glomerular diseases like N02.1. This specificity aids in better tracking of disease prevalence and management outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of renal conditions, improving the ability to capture the nuances of glomerular diseases like N02.1. This specificity aids in better tracking of disease prevalence and management outcomes.

Resources

Clinical References

  • •
    American Academy of Nephrology

Coding & Billing References

  • •
    American Academy of Nephrology

Frequently Asked Questions

What is the significance of focal and segmental glomerular lesions?

Focal and segmental glomerular lesions indicate localized damage to the glomeruli, which can lead to significant renal impairment and are often associated with specific types of glomerular diseases.