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N04.B ICD-10-CM Code: Nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)

N04.B is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

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FY 2026 Apr update / Diseases of the genitourinary system (N00-N99) / Glomerular diseases (N00-N08)

N04.B

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)

Nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)

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

Official
N04Nephrotic syndrome
N04.BNephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for N04.B in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for N04.B in this effective period.

Related Child Codes

Official
N04.B1Nephrotic syndrome with idiopathic immune complex membranoproliferative glomerulonephritis (IC-MPGN)
N04.B2Nephrotic syndrome with secondary immune complex membranoproliferative glomerulonephritis (IC-MPGN)

Includes

Official
  • congenital nephrotic syndrome
  • lipoid nephrosis

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for N04.B in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for N04.B in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for N04.B in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for N04.B in this effective period.

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 →

Code
N04.B
Description
Nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

N04.B is the ICD-10-CM diagnosis code for nephrotic syndrome with immune complex membranoproliferative glomerulonephritis (ic-mpgn). N04.B sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering glomerular diseases (n00-n08).

Header codes like N04.B cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at N04.B's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N04.B sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

N04Nephrotic syndromeN04.BNephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)
N04.BNephrotic syndrome with immune complex membranoproliferative glomerulonephritis (IC-MPGN)

N04.B code history

Code setChange
FY2026 (effective Oct 1, 2025)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

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