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v1.0.0
ICD-10 Guide
ICD-10 CodesN05.0

N05.0

Billable

Unspecified nephritic syndrome with minor glomerular abnormality

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

Code Description

ICD-10 N05.0 is a billable code used to indicate a diagnosis of unspecified nephritic syndrome with minor glomerular abnormality.

Key Diagnostic Point:

Unspecified nephritic syndrome with minor glomerular abnormality refers to a clinical condition characterized by the presence of nephritis, which is inflammation of the kidneys, leading to a range of symptoms including proteinuria (excess protein in urine), hematuria (blood in urine), and hypertension. This syndrome is often associated with minor glomerular abnormalities that may not be clearly defined or categorized. Patients typically present with edema, fatigue, and changes in urine output. Diagnosis often involves renal biopsy, which may reveal minimal changes in glomerular structure, indicating a less severe form of glomerulonephritis. Management typically includes controlling blood pressure, reducing proteinuria, and addressing any underlying conditions. The prognosis can vary, with some patients experiencing complete recovery while others may progress to more severe kidney disease. Accurate coding is essential for appropriate treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for renal biopsy results to confirm diagnosis
  • Differentiation from other nephritic and nephrotic syndromes
  • Potential for overlapping symptoms with other renal conditions

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the type of nephritic syndrome
  • Misinterpretation of renal biopsy results
  • Inconsistent coding of related conditions

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical notes on symptoms, lab results, and renal biopsy findings.

Common Clinical Scenarios

Patients presenting with edema, hypertension, and abnormal urinalysis results.

Billing Considerations

Ensure that all relevant lab tests and imaging studies are documented to support the diagnosis.

Primary Care

Documentation Requirements

Comprehensive patient history and physical examination findings.

Common Clinical Scenarios

Initial evaluation of patients with suspected kidney issues based on routine lab tests.

Billing Considerations

Referral to nephrology should be documented when specialized care is needed.

Coding Guidelines

Inclusion Criteria

Use N05.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include details about the patient's symptoms, lab results, and any treatments provided

Exclusion Criteria

Do NOT use N05.0 When
  • Exclude codes that specify other types of nephritic syndrome or those with significant glomerular abnormalities

Related ICD-10 Codes

Related CPT Codes

Renal biopsy CPT codeCPT Code

Renal biopsy

Clinical Scenario

Used when renal biopsy is performed to confirm diagnosis of nephritic syndrome.

Documentation Requirements

Biopsy report must be included in the patient's medical record.

Specialty Considerations

Nephrology specialists should ensure that biopsy findings are clearly documented.

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 diagnoses and treatment plans. N05.0 provides a clear classification for unspecified nephritic syndrome with minor glomerular abnormalities, facilitating better patient management and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of nephritic syndromes, improving the accuracy of diagnoses and treatment plans. N05.0 provides a clear classification for unspecified nephritic syndrome with minor glomerular abnormalities, facilitating better patient management and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common symptoms of unspecified nephritic syndrome?

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

How is a renal biopsy used in diagnosing nephritic syndrome?

A renal biopsy is performed to obtain kidney tissue for examination, which helps determine the presence and extent of glomerular abnormalities, aiding in the diagnosis of nephritic syndrome.

What is the difference between nephritic syndrome and nephrotic syndrome?

Nephritic syndrome is characterized by hematuria, hypertension, and mild proteinuria, while nephrotic syndrome is defined by significant proteinuria, hypoalbuminemia, and edema.