N04.1 — Nephrotic syndrome with focal and segmental glomerular lesions
N04.1 is a billable, specific ICD-10-CM code for nephrotic syndrome with focal and segmental glomerular lesions. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Nephrotic syndrome with focal and segmental hyalinosis
- Nephrotic syndrome with focal and segmental sclerosis
- Nephrotic syndrome with focal glomerulonephritis
Risk adjustment
N04.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
N04.1 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56380Billing and Coding: Rituximab
- A57189Billing and Coding: Serum Magnesium
- A58921Billing and Coding: Mass Spectrometry (MS) Testing in Monoclonal Gammopathy (MG)
How N04.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to N04.1.
- Nephrosis, nephrotic›with›glomerular lesion
- Syndrome›nephrotic›with›focal and segmental glomerular lesions
Related codes at this level
Codes that share N04. If N04.1 is not quite right, the correct code is usually one of these.
- N04.0Nephrotic syndrome with minor glomerular abnormality
- N04.2Nephrotic syndrome with diffuse membranous glomerulonephritis
- N04.3Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis
- N04.4Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritis
- N04.5Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis
- N04.6Nephrotic syndrome with dense deposit disease
- N04.7Nephrotic syndrome with diffuse crescentic glomerulonephritis
- N04.8Nephrotic syndrome with other morphologic changes
- N04.9Nephrotic syndrome with unspecified morphologic changes
- N04.ANephrotic syndrome with C3 glomerulonephritis
- N04.BNephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)
Questions about N04.1
- Is N04.1 a billable ICD-10-CM code?
- Yes. N04.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does N04.1 sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Glomerular diseases (N00-N08).