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2025 ICD-10-CM code N04.9

Nephrotic syndrome with unspecified morphologic changes.

Code also any associated kidney failure (N17-N19).Do not use this code if a more specific morphologic diagnosis is available. This code should not be used for conditions originating in the perinatal period, certain infectious and parasitic diseases, complications of pregnancy, childbirth and the puerperium, congenital malformations, deformations and chromosomal abnormalities, endocrine, nutritional and metabolic diseases, injury, poisoning and certain other consequences of external causes, neoplasms, or symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified.

Medical necessity for the services rendered is established by the diagnosis of nephrotic syndrome, its severity, and the need for ongoing monitoring and treatment.Documentation should clearly link the provided services to the patient's condition and the plan of care.

Diagnosis and management of the nephrotic syndrome fall under the purview of nephrologists (kidney specialists).They perform necessary investigations like urine and blood tests, kidney biopsies if required, and determine the underlying cause if possible. Treatment focuses on managing symptoms, reducing proteinuria, controlling blood pressure and preventing complications.

In simple words: This code refers to a kidney problem where the body loses too much protein in the urine. The exact reason or changes in the kidney causing this are unknown.

Nephrotic syndrome is a kidney disorder that causes the body to excrete too much protein in the urine.This specific code is used when the underlying cause or structural changes in the kidney associated with the nephrotic syndrome are not specified or unknown.

Example 1: A patient presents with swelling in the legs, foamy urine, and fatigue. Lab tests reveal significant proteinuria and hypoalbuminemia.The cause of the nephrotic syndrome has not yet been determined. N04.9 is used until a definitive diagnosis is made., A child is found to have protein in their urine during a routine check-up. Further investigations suggest nephrotic syndrome, but a kidney biopsy is inconclusive regarding specific morphologic changes. N04.9 is assigned., A patient with a history of diabetes develops nephrotic syndrome.While diabetic nephropathy is suspected, the specific morphologic changes are not confirmed.N04.9 is used until further testing can be done.Any associated kidney failure would be coded separately.

Documentation should include signs and symptoms such as edema, foamy urine, weight gain; laboratory findings confirming proteinuria, hypoalbuminemia, and hyperlipidemia;results of any imaging studies (ultrasound, biopsy) and details regarding the extent of kidney damage; and any associated conditions or complications.

  • Specialties:Nephrology
  • Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Office
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