N04.8
BillableNephrotic syndrome with other morphologic changes
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is N04.8 an HCC code?
No. N04.8 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
N04.8 is the ICD-10-CM diagnosis code for nephrotic syndrome with other morphologic changes. A kidney condition where protein leaks into the urine due to damage to the kidney's filtering units, with specific structural changes that don't fit other categories. N04.8 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering glomerular diseases (n00-n08).
N04.8 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.
Use this code when the morphologic changes are documented but don't match N04.0-N04.7 categories.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N04.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.