Version 2024

2024 ICD-10-CM Diagnosis Code N04.21

Primary membranous nephropathy with nephrotic syndrome

ICD-10-CM Code:: N04.21
ICD-10 Code for:: Primary membranous nephropathy with nephrotic syndrome
Is Billable?: Yes - Valid for Submission
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Code Information
2024 ICD-10 Code
Tabular List of Diseases and Injuries
Index to Diseases and Injuries References
Diagnostic Related Groups Mapping
Replacement Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the genitourinary system
(N00–N99)
- Glomerular diseases
  (N00-N08)
  - Nephrotic syndrome
    (N04)

N04.21 is a billable diagnosis code used to specify a medical diagnosis of primary membranous nephropathy with nephrotic syndrome. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

New 2024 ICD-10-CM Code

N04.21 is new to ICD-10-CM code set for the FY 2024, effective October 1, 2023. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2023. This is a new and revised code for the FY 2024 (October 1, 2023 - September 30, 2024).

Tabular List of Diseases and Injuries

The following annotation back-references are applicable to this diagnosis code. The Tabular List of Diseases and Injuries is a list of ICD-10-CM codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more.

Inclusion Terms

Idiopathic membranous nephropathy with nephrotic syndrome

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Nephropathy - See Also: Nephritis; - N28.9
- - membranous (diffuse) - N06.20
  - - with
    - - nephrotic syndrome - N04.20
      - - primary - N04.21
  - - idiopathic, with nephrotic syndrome - N04.21
  - - primary - N06.21
    - - with nephrotic syndrome - N04.21

N04.21 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
698	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC	11	1.6544
699	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC	11	1.0208
700	OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC	11	0.7083

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Replacement Code

N0421 replaces the following previously assigned ICD-10-CM code(s):

N04.2 - Nephrotic syndrome w diffuse membranous glomerulonephritis

Code History

FY 2024 - Code Added, effective from 10/1/2023 through 9/30/2024