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ICD-10 Guide
ICD-10 CodesN05.9

N05.9

Billable

Unspecified nephritic syndrome with unspecified morphologic changes

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

Code Description

ICD-10 N05.9 is a billable code used to indicate a diagnosis of unspecified nephritic syndrome with unspecified morphologic changes.

Key Diagnostic Point:

Unspecified nephritic syndrome is characterized by a group of symptoms that indicate kidney inflammation, primarily affecting the glomeruli. This condition may present with proteinuria, hematuria, and hypertension, leading to edema and renal impairment. The term 'unspecified' indicates that the exact type of nephritic syndrome has not been determined, which can complicate diagnosis and treatment. Nephritic syndrome often results from various underlying causes, including infections, autoimmune diseases, and systemic conditions. The morphologic changes in the kidneys may not be clearly defined, making it challenging to pinpoint the exact pathology. Diagnosis typically involves laboratory tests showing elevated serum creatinine, urinalysis revealing red blood cells and protein, and possibly a renal biopsy to assess the extent of glomerular damage. Management may include controlling blood pressure, reducing proteinuria, and addressing the underlying cause, which may involve immunosuppressive therapy or other targeted treatments.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for comprehensive laboratory and imaging studies
  • Potential for overlapping symptoms with other renal conditions
  • Documentation of renal biopsy findings can be complex

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify underlying causes or associated conditions
  • Misinterpretation of laboratory results
  • Inconsistent coding of related diagnoses

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical history, laboratory results, imaging studies, and renal biopsy findings.

Common Clinical Scenarios

Patients presenting with hematuria and proteinuria, acute kidney injury, or chronic kidney disease with nephritic features.

Billing Considerations

Ensure clear documentation of symptoms, laboratory values, and treatment plans to support the diagnosis.

Internal Medicine

Documentation Requirements

Comprehensive patient history, physical examination findings, and relevant lab tests.

Common Clinical Scenarios

Management of patients with systemic diseases presenting with renal symptoms.

Billing Considerations

Documentation should reflect the systemic nature of the disease and its impact on renal function.

Coding Guidelines

Inclusion Criteria

Use N05.9 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of symptoms, laboratory findings, and treatment plans
  • Include any relevant history of systemic diseases or infections that may contribute to the nephritic syndrome

Exclusion Criteria

Do NOT use N05.9 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 determine the underlying cause of nephritic syndrome.

Documentation Requirements

Document indications for biopsy, findings, and any complications.

Specialty Considerations

Nephrologists should ensure that the biopsy results are clearly linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of nephritic syndromes, improving the accuracy of data collection and reimbursement processes. However, the unspecified nature of N05.9 may lead to challenges in justifying claims and ensuring appropriate reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of nephritic syndromes, improving the accuracy of data collection and reimbursement processes. However, the unspecified nature of N05.9 may lead to challenges in justifying claims and ensuring appropriate reimbursement.

Reimbursement & Billing Impact

reimbursement processes. However, the unspecified nature of N05.9 may lead to challenges in justifying claims and ensuring appropriate reimbursement.

Resources

Clinical References

  • •
    American Academy of Nephrology

Coding & Billing References

  • •
    American Academy of Nephrology

Frequently Asked Questions

What are the common symptoms of nephritic syndrome?

Common symptoms include hematuria, proteinuria, hypertension, and edema. Patients may also experience fatigue and decreased urine output.

How is nephritic syndrome diagnosed?

Diagnosis typically involves urinalysis showing hematuria and proteinuria, blood tests for renal function, and often a renal biopsy to assess the underlying cause.

What is the treatment for unspecified nephritic syndrome?

Treatment focuses on managing symptoms and addressing the underlying cause, which may include medications to control blood pressure, reduce proteinuria, and immunosuppressive therapy if indicated.