ICD-10 · PDGM grouping
N04 Nephrotic syndrome
All 16 codes in the N04 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
16
Can lead a claim
15
Cannot lead a claim
1
What CMS assigns to N04
15 of the 16 codes group to MMTA - Gastrointestinal tract and Genitourinary system (13) and MMTA - Other (2); 1 is assigned no clinical group. 1 of the 16 counts toward the Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD comorbidity subgroup; 15 are assigned none. 15 of the 16 can lead a claim. CMS attaches a code-first note to 1 of the 16.
- Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD: counts toward the high comorbidity tier only in an interaction pair.
Code first
CMS grouper convention 12, on N04.22. Code first:
- underlying disease
Every code in N04
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| N04.0 | Nephrotic syndrome with minor glomerular abnormality | Can lead a claim | J | None |
| N04.1 | Nephrotic syndrome with focal and segmental glomerular lesionsCMS: Nephrotic syndrome w focal and segmental glomerular lesions | Can lead a claim | J | None |
| N04.2 Nephrotic syndrome with diffuse membranous glomerulonephritis | ||||
| N04.20 | Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecifiedCMS: Nephrotic syndrome with diffuse membranous glomrlneph, unsp | Can lead a claim | J | None |
| N04.21 | Primary membranous nephropathy with nephrotic syndrome | Can lead a claim | J | None |
| N04.22 | Secondary membranous nephropathy with nephrotic syndrome | Can lead a claim, code first applies | J | None |
| N04.29 | Other nephrotic syndrome with diffuse membranous glomerulonephritisCMS: Other nephrotic syndrome with diffuse membranous glomrlneph | Can lead a claim | J | None |
| N04.3 | Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritisCMS: Nephrotic syndrome w diffuse mesangial prolif glomrlneph | Can lead a claim | J | None |
| N04.4 | Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritisCMS: Nephrotic syndrome w diffuse endocaplry prolif glomrlneph | Can lead a claim | J | None |
| N04.5 | Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritisCMS: Nephrotic syndrome w diffuse mesangiocapillary glomrlneph | Can lead a claim | A | None |
| N04.6 | Nephrotic syndrome with dense deposit disease | Can lead a claim | A | None |
| N04.7 | Nephrotic syndrome with diffuse crescentic glomerulonephritisCMS: Nephrotic syndrome w diffuse crescentic glomerulonephritis | Can lead a claim | J | None |
| N04.8 | Nephrotic syndrome with other morphologic changes | Can lead a claim | J | None |
| N04.9 | Nephrotic syndrome with unspecified morphologic changes | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| N04.A | Nephrotic syndrome with C3 glomerulonephritis | Can lead a claim | J | Other disorders of the kidney and ureter, excluding chronic kidney disease and ESRD |
| N04.B Nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN) | ||||
| N04.B1 | Nephrotic syndrome with idiopathic immune complex membranoproliferative glomerulonephritis (IC-MPGN)CMS: Nep syn w idio imm cmplx membr prolif glomrlneph (IC-MPGN) | Can lead a claim | J | None |
| N04.B2 | Nephrotic syndrome with secondary immune complex membranoproliferative glomerulonephritis (IC-MPGN)CMS: Nep syn with sec imm cmplx membr prolif glomrlneph (IC-MPGN) | Can lead a claim | J | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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