N05.4
BillableUnspecified nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is N05.4 an HCC code?
No. N05.4 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
N05.4 is the ICD-10-CM diagnosis code for unspecified nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis. A kidney condition causing blood and protein in the urine where the inner lining cells of the kidney's filtering capillaries are overgrown throughout the kidney. N05.4 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering glomerular diseases (n00-n08).
N05.4 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.
Endocapillary proliferation indicates cell growth within the capillary loops.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for N05.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Endocapillary proliferation indicates cell growth within the capillary loops
- •Often associated with post-infectious glomerulonephritis or lupus nephritis