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N05.9
ICD-10-CM
Glomerulonephritis

Understand glomerulonephritis diagnosis, symptoms, and treatment. Find information on ICD-10 codes for glomerulonephritis, medical coding guidelines, clinical documentation improvement tips, and healthcare resources for patients and professionals. Learn about acute glomerulonephritis, chronic glomerulonephritis, nephrotic syndrome, kidney disease, renal failure, proteinuria, hematuria, and hypertension related to glomerulonephritis. Explore effective management strategies and the latest research in glomerulonephritis care.

Also known as

GN
Kidney inflammation

Diagnosis Snapshot

Key Facts
  • Definition : Kidney inflammation affecting the glomeruli, causing blood and protein leakage into urine.
  • Clinical Signs : Swelling, high blood pressure, foamy urine, fatigue, decreased urine output.
  • Common Settings : Primary care, nephrology clinic, hospital inpatient/outpatient.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC N05.9 Coding
N00-N08

Glomerular diseases

Conditions primarily affecting the kidney's filtering units.

N10-N16

Renal tubulo-interstitial diseases

Diseases affecting the kidney's tubules and surrounding tissue.

I10-I15

Hypertensive diseases

High blood pressure and related complications, often linked to kidney disease.

N04

Nephrotic syndrome

Kidney disorder characterized by proteinuria and edema, often due to glomerular damage.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the glomerulonephritis caused by a systemic disease?

  • Yes

    Is it due to Lupus?

  • No

    Is it rapidly progressive?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Kidney inflammation (glomeruli)
IgA Nephropathy (Berger's)
Post-streptococcal GN

Documentation Best Practices

Documentation Checklist
  • Document onset and duration of symptoms (hematuria, edema, proteinuria)
  • Record blood pressure and GFR measurements
  • Specify type of glomerulonephritis (e.g., IgA, post-streptococcal)
  • Document relevant lab results (urine protein, creatinine)
  • Note any related conditions (e.g., lupus, infections)

Coding and Audit Risks

Common Risks
  • Specificity of GN type

    Coding lacks specificity, e.g., unspecified GN when documentation supports a more specific type. Impacts reimbursement and data accuracy.

  • Acute vs. Chronic GN

    Incorrectly coding acute or chronic GN based on documentation. Affects severity reporting and quality metrics.

  • Underlying cause coding

    Failure to code underlying causes (e.g., lupus, infections) impacting data analysis and case mix index.

Mitigation Tips

Best Practices
  • Document proteinuria, hematuria for ICD-10 B71.* coding accuracy.
  • Specify GN type (e.g., IgA, membranous) for optimal CDI, reimbursement.
  • Review prior labs, biopsies for chronic vs. acute GN for correct HCC capture.
  • Ensure complete renal function documentation for accurate severity staging.
  • Query physician for GN etiology (e.g., lupus, infection) to improve RAF scores.

Clinical Decision Support

Checklist
  • Verify elevated creatinine/BUN, proteinuria via urinalysis
  • Check for hematuria, edema, hypertension documentation
  • Confirm recent strep infection, autoimmune disease history
  • Review complement levels, renal biopsy results if available
  • Assess GFR for staging and treatment planning documentation

Reimbursement and Quality Metrics

Impact Summary
  • Glomerulonephritis reimbursement hinges on accurate ICD-10-CM coding (N00-N08) and appropriate documentation of acuity, impacting MS-DRG assignment and payment.
  • Coding errors for Glomerulonephritis can lead to claim denials, impacting revenue cycle and requiring costly appeals. Proper specificity (acute, chronic, etc.) is crucial.
  • Quality metrics for Glomerulonephritis include proteinuria management, blood pressure control, and timely nephrology referral. Accurate coding reflects these efforts.
  • Hospital reporting for Glomerulonephritis impacts quality scores tied to value-based purchasing and public reporting initiatives. Accurate data is essential.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code GN type, stage, cause
  • Document proteinuria, hematuria
  • Check for hypertension coding
  • Consider CKD stage with GN
  • Code biopsy findings if present

Documentation Templates

Patient presents with signs and symptoms suggestive of glomerulonephritis.  Presenting complaints include hematuria, proteinuria, edema, hypertension, and reduced urine output.  Onset of symptoms reported as [Onset timeframe - e.g., gradual over several weeks, acute onset 2 days ago].  Patient history includes [Relevant past medical history e.g., recent streptococcal infection, systemic lupus erythematosus, diabetes, hypertension].  Physical examination reveals [Specific findings e.g., periorbital edema, lower extremity edema, elevated blood pressure].  Laboratory findings demonstrate [Specific lab results e.g., elevated creatinine, decreased glomerular filtration rate (GFR), presence of red blood cell casts in urine, abnormal urine protein creatinine ratio].  Differential diagnosis includes acute glomerulonephritis, chronic glomerulonephritis, nephrotic syndrome, IgA nephropathy, and lupus nephritis.  Based on the clinical presentation, laboratory findings, and patient history, the presumptive diagnosis is [Specific type of glomerulonephritis e.g., post-streptococcal glomerulonephritis, membranoproliferative glomerulonephritis].  Plan includes further investigation with [Diagnostic tests ordered e.g., renal biopsy, complement levels, anti-streptolysin O titer].  Treatment plan includes [Medications and therapies prescribed e.g., blood pressure management with ACE inhibitors or ARBs, dietary modifications including sodium restriction, diuretics for edema management].  Patient education provided regarding disease process, medication management, and potential complications including acute kidney injury and chronic kidney disease.  Follow-up scheduled for [Follow-up timeframe] to monitor renal function, blood pressure control, and response to therapy.  ICD-10 code [Appropriate ICD-10 code e.g., N00.x for acute glomerulonephritis, N03.x for chronic glomerulonephritis].
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