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ICD-10 Guide
ICD-10 CodesN03.4

N03.4

Billable

Chronic nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis

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

Code Description

ICD-10 N03.4 is a billable code used to indicate a diagnosis of chronic nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis.

Key Diagnostic Point:

Chronic nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis is characterized by persistent inflammation of the glomeruli, leading to significant renal impairment. This condition is marked by the presence of hematuria, proteinuria, and hypertension. Patients often present with edema and may experience renal insufficiency over time. The diffuse endocapillary proliferation indicates an increase in the number of cells within the capillary loops of the glomeruli, which can be identified through renal biopsy. This condition can be secondary to various underlying diseases, including infections, autoimmune disorders, or systemic diseases. Management typically involves controlling blood pressure, reducing proteinuria, and addressing the underlying cause, which may include immunosuppressive therapy. Regular monitoring of renal function and urinalysis is essential to assess disease progression and treatment efficacy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of nephrology terminology and conditions.
  • Differentiation from other types of nephritic syndromes.
  • Need for precise documentation of clinical findings.
  • Potential overlap with other renal codes.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the type of glomerulonephritis.
  • Misclassification of nephrotic vs. nephritic syndrome.
  • Lack of follow-up documentation on renal function.

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical notes on symptoms, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with hematuria, proteinuria, and renal insufficiency.

Billing Considerations

Ensure accurate representation of biopsy findings and treatment response.

Internal Medicine

Documentation Requirements

Comprehensive history and physical examination notes, including comorbidities.

Common Clinical Scenarios

Management of chronic kidney disease with nephritic syndrome.

Billing Considerations

Coordination with nephrology for complex cases.

Coding Guidelines

Inclusion Criteria

Use N03.4 When
  • According to ICD
  • 10 guidelines, this code should be used when there is clear documentation of chronic nephritic syndrome with specific findings of diffuse endocapillary proliferative glomerulonephritis
  • It is essential to document the duration of symptoms and any relevant laboratory findings

Exclusion Criteria

Do NOT use N03.4 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 confirm the diagnosis of chronic nephritic syndrome.

Documentation Requirements

Document indication for biopsy, findings, and any complications.

Specialty Considerations

Nephrology specialists should ensure proper coding based on biopsy results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of chronic nephritic syndrome, improving the accuracy of patient records and facilitating better management of renal diseases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chronic nephritic syndrome, improving the accuracy of patient records and facilitating better management of renal diseases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of chronic nephritic syndrome, improving the accuracy of patient records and facilitating better management of renal diseases.

Resources

Clinical References

  • •
    American Academy of Nephrology

Coding & Billing References

  • •
    American Academy of Nephrology

Frequently Asked Questions

What are the key symptoms of chronic nephritic syndrome?

Key symptoms include hematuria, proteinuria, hypertension, and edema. Patients may also experience fatigue and renal insufficiency.