Is N04 a billable ICD-10-CM code?

No. N04 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does N04 sit in the tabular list?

Diseases of the genitourinary system (N00-N99), in the block Glomerular diseases (N00-N08).

N04

N04 — Nephrotic syndrome

Non-billable headerICD-10-CM

N04 is a non-billable header ICD-10-CM code for nephrotic syndrome. It cannot be billed on its own: choose one of the more specific child codes below.

Includes

Conditions this code covers.

congenital nephrotic syndrome
lipoid nephrosis

Other codes that can never be billed with N04

These codes carry an Excludes1 note pointing at N04. 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 alone.

N04.5Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis
N04.ANephrotic syndrome with C3 glomerulonephritis
N06.20Isolated proteinuria with diffuse membranous glomerulonephritis, unspecified
N06.21Primary membranous nephropathy with isolated proteinuria
N06.22Secondary membranous nephropathy with isolated proteinuria
Q63Other congenital malformations of kidney

Risk adjustment

N04 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.

Code to one of these instead N04

12 child codes. Green means billable.

Questions about N04

Is N04 a billable ICD-10-CM code?: No. N04 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does N04 sit in the tabular list?: Diseases of the genitourinary system (N00-N99), in the block Glomerular diseases (N00-N08).