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v1.0.0
ICD-10 Guide
ICD-10 CodesN06.1

N06.1

Billable

Isolated proteinuria with focal and segmental glomerular lesions

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

Code Description

ICD-10 N06.1 is a billable code used to indicate a diagnosis of isolated proteinuria with focal and segmental glomerular lesions.

Key Diagnostic Point:

Isolated proteinuria with focal and segmental glomerular lesions refers to a condition characterized by the presence of protein in the urine without significant accompanying symptoms or systemic disease. This condition is often identified through routine urinalysis, where protein levels are elevated. The focal and segmental glomerular lesions indicate localized damage to the glomeruli, the filtering units of the kidneys, which can be due to various underlying causes, including hereditary nephropathies, such as Alport syndrome or minimal change disease. These lesions can lead to nephron damage and progressive renal impairment if not monitored and managed appropriately. The condition may also be associated with other glomerular disorders classified elsewhere, necessitating a thorough evaluation to determine the underlying etiology. Genetic testing may be considered in cases where hereditary nephropathy is suspected, aiding in diagnosis and management decisions. Understanding the nuances of isolated proteinuria and its implications is crucial for effective patient care and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other types of proteinuria
  • Need for comprehensive patient history and documentation
  • Potential overlap with other renal conditions
  • Genetic testing considerations

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of proteinuria
  • Lack of genetic testing results when indicated
  • Misclassification of the underlying cause

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical notes on renal function, urinalysis results, and any imaging studies.

Common Clinical Scenarios

Patients presenting with unexplained proteinuria, follow-up of known glomerular diseases, and evaluation of hereditary nephropathies.

Billing Considerations

Ensure that all relevant lab results and genetic testing outcomes are documented to support the diagnosis.

Genetics

Documentation Requirements

Family history, results of genetic testing, and any relevant phenotypic information.

Common Clinical Scenarios

Assessment of patients with suspected hereditary nephropathies and counseling for family members.

Billing Considerations

Documentation should clearly outline the rationale for genetic testing and its implications for management.

Coding Guidelines

Inclusion Criteria

Use N06.1 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include any relevant lab results and imaging studies that confirm the presence of focal and segmental glomerular lesions

Exclusion Criteria

Do NOT use N06.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

84156CPT Code

Urine protein, total

Clinical Scenario

Used to quantify protein levels in urine for diagnosis of proteinuria.

Documentation Requirements

Document the reason for the test and any relevant clinical findings.

Specialty Considerations

Nephrologists should ensure that the test results correlate with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more precise coding of renal conditions, including isolated proteinuria with focal and segmental glomerular lesions, facilitating better tracking of disease prevalence and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more precise coding of renal conditions, including isolated proteinuria with focal and segmental glomerular lesions, facilitating better tracking of disease prevalence and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more precise coding of renal conditions, including isolated proteinuria with focal and segmental glomerular lesions, facilitating better tracking of disease prevalence and outcomes.

Resources

Clinical References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Coding & Billing References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Frequently Asked Questions

What is the significance of focal and segmental glomerular lesions?

Focal and segmental glomerular lesions indicate localized damage to the kidney's filtering units, which can lead to chronic kidney disease if not properly managed. They are often associated with specific types of kidney disease, including hereditary nephropathies.