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ICD-10 Guide
ICD-10 CodesN03.1

N03.1

Billable

Chronic nephritic syndrome with focal and segmental glomerular lesions

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

Code Description

ICD-10 N03.1 is a billable code used to indicate a diagnosis of chronic nephritic syndrome with focal and segmental glomerular lesions.

Key Diagnostic Point:

Chronic nephritic syndrome with focal and segmental glomerular lesions is characterized by persistent inflammation of the kidneys, leading to damage primarily affecting specific areas of the glomeruli. This condition often presents with symptoms such as proteinuria (excess protein in urine), hematuria (blood in urine), and hypertension. The focal and segmental nature of the lesions indicates that only certain parts of the glomeruli are affected, which can lead to varying degrees of renal impairment. Patients may experience edema and reduced renal function over time. Diagnosis typically involves renal biopsy, which reveals the characteristic histological findings of focal segmental glomerulosclerosis (FSGS). Management may include corticosteroids, immunosuppressive agents, and supportive care to control hypertension and proteinuria. Regular monitoring of renal function and urine protein levels is essential to assess disease progression and treatment efficacy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for precise documentation of renal biopsy findings
  • Differentiation from other types of nephritic syndromes
  • Potential for co-morbid conditions affecting renal function

Audit Risk Factors

  • Inadequate documentation of biopsy results
  • Failure to document the presence of proteinuria and hematuria
  • Misclassification of nephritic versus nephrotic 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 edema, hypertension, and abnormal urinalysis findings.

Billing Considerations

Ensure accurate documentation of renal biopsy findings and response to treatment.

Pathology

Documentation Requirements

Comprehensive pathology reports detailing glomerular lesions.

Common Clinical Scenarios

Biopsy specimens from patients with suspected glomerular disease.

Billing Considerations

Clear communication with nephrologists regarding findings and implications for treatment.

Coding Guidelines

Inclusion Criteria

Use N03.1 When
  • Follow ICD
  • CM guidelines for coding nephritic syndrome, ensuring accurate documentation of the specific type of glomerular lesions
  • Include relevant clinical findings and treatment plans in the medical record

Exclusion Criteria

Do NOT use N03.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

88172CPT Code

Pathology consultation for renal biopsy

Clinical Scenario

Used when a renal biopsy is performed to assess glomerular lesions.

Documentation Requirements

Pathology report detailing findings and correlation with clinical symptoms.

Specialty Considerations

Nephrologists should ensure clear communication with pathologists regarding clinical context.

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 syndromes, 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 syndromes, 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 syndromes, improving the accuracy of patient records and facilitating better management of renal diseases.

Resources

Clinical References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Coding & Billing References

  • •
    Kidney Disease: Improving Global Outcomes (KDIGO)

Frequently Asked Questions

What are the key symptoms of chronic nephritic syndrome?

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