N04.3 ICD-10-CM Code: Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the genitourinary system (N00-N99) / Glomerular diseases (N00-N08)
N04.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNephrotic syndrome with diffuse mesangial proliferative glomerulonephritis
A kidney disorder where cells in the kidney's filtering units multiply abnormally throughout the kidneys, causing protein loss and fluid retention.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for N04.3 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for N04.3 in this effective period.
Related Child Codes
Includes
Official- congenital nephrotic syndrome
- lipoid nephrosis
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for N04.3 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for N04.3 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for N04.3 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for N04.3 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is N04.3 an HCC code?
No. N04.3 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- N04.3
- Description
- Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
N04.3 is the ICD-10-CM diagnosis code for nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis. A kidney disorder where cells in the kidney's filtering units multiply abnormally throughout the kidneys, causing protein loss and fluid retention. N04.3 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering glomerular diseases (n00-n08).
N04.3 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Mesangial proliferative glomerulonephritis involves proliferation of cells in the mesangium; ensure this is documented in the pathology report.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N04.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Mesangial proliferative glomerulonephritis involves proliferation of cells in the mesangium; ensure this is documented in the pathology report
- •This pattern is often seen in IgA nephropathy and lupus; document any associated conditions