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ICD-10 Guide
ICD-10 CodesN06.4

N06.4

Billable

Isolated proteinuria with diffuse endocapillary proliferative glomerulonephritis

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

Code Description

ICD-10 N06.4 is a billable code used to indicate a diagnosis of isolated proteinuria with diffuse endocapillary proliferative glomerulonephritis.

Key Diagnostic Point:

Isolated proteinuria with diffuse endocapillary proliferative glomerulonephritis is a condition characterized by the presence of excess protein in the urine (proteinuria) without other significant renal impairment. This condition is often associated with diffuse endocapillary proliferative glomerulonephritis, which is a type of kidney inflammation affecting the glomeruli, the filtering units of the kidneys. The endocapillary proliferation refers to the increase in the number of cells within the capillary loops of the glomeruli, leading to impaired kidney function over time. Patients may present with symptoms such as edema, hypertension, and hematuria, although some may be asymptomatic. The etiology can be idiopathic or secondary to systemic diseases such as lupus or infections. Genetic factors may also play a role, particularly in hereditary nephropathies. Diagnosis typically involves urinalysis, serum creatinine levels, and sometimes kidney biopsy to confirm the presence of glomerular inflammation. Management focuses on controlling underlying conditions, reducing proteinuria, and monitoring kidney function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary causes of proteinuria
  • Need for comprehensive documentation of clinical findings
  • Potential overlap with other glomerular disorders
  • Variability in presentation and laboratory findings

Audit Risk Factors

  • Inadequate documentation of proteinuria severity
  • Failure to specify the type of glomerulonephritis
  • Lack of supporting lab results
  • Misclassification of primary vs. secondary causes

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed clinical history, laboratory results, and imaging studies.

Common Clinical Scenarios

Patients presenting with unexplained proteinuria, hypertension, or edema.

Billing Considerations

Ensure clear documentation of the type of glomerulonephritis and any associated systemic conditions.

Genetics

Documentation Requirements

Family history, genetic testing results, and clinical findings.

Common Clinical Scenarios

Patients with a family history of kidney disease or unexplained renal symptoms.

Billing Considerations

Document any genetic testing performed and its implications for diagnosis and treatment.

Coding Guidelines

Inclusion Criteria

Use N06.4 When
  • Follow ICD
  • CM guidelines for coding proteinuria and glomerulonephritis
  • Ensure that the documentation supports the diagnosis, including laboratory findings and clinical symptoms

Exclusion Criteria

Do NOT use N06.4 When
  • Exclude conditions that may lead to similar presentations unless they are specifically documented

Related ICD-10 Codes

Related CPT Codes

80061CPT Code

Lipid panel

Clinical Scenario

Often ordered alongside renal function tests in patients with proteinuria.

Documentation Requirements

Document the reason for the lipid panel in relation to kidney disease.

Specialty Considerations

Nephrologists may order this test to assess cardiovascular risk in patients with chronic kidney disease.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like isolated proteinuria, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like isolated proteinuria, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of patient outcomes and resource allocation.

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 is the significance of isolated proteinuria?

Isolated proteinuria can indicate early kidney disease and may require further evaluation to determine the underlying cause. It is essential to monitor and manage to prevent progression to chronic kidney disease.