N04.A — Nephrotic syndrome with C3 glomerulonephritis
N04.A is a billable, specific ICD-10-CM code for nephrotic syndrome with c3 glomerulonephritis. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- Nephrotic syndrome (with C3 glomerulopathy) with dense deposit disease (N04.6)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Nephrotic syndrome with C3 glomerulopathy
Other codes that can never be billed with N04.A
These codes carry an Excludes1 note pointing at N04.A. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading N04.A alone.
- N04.5Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis
Risk adjustment
N04.A 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.A is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
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How N04.A 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.A.
- Syndrome›nephrotic›with›C3›glomerulonephritis
- Syndrome›nephrotic›with›C3›glomerulopathy
Related codes at this level
Codes that share N04. If N04.A is not quite right, the correct code is usually one of these.
- N04.0Nephrotic syndrome with minor glomerular abnormality
- N04.1Nephrotic syndrome with focal and segmental glomerular lesions
- 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.BNephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)
Questions about N04.A
- Is N04.A a billable ICD-10-CM code?
- Yes. N04.A is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does N04.A sit in the tabular list?
- Diseases of the genitourinary system (N00-N99), in the block Glomerular diseases (N00-N08).
- What cannot be coded together with N04.A?
- N04.A carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.