ICD-10 Coding for Focal Segmental Glomerulosclerosis(N04.1)
Complete ICD-10-CM coding and documentation guide for Focal Segmental Glomerulosclerosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Focal Segmental Glomerulosclerosis
N00-N08Primary Range
Glomerular diseases
This range includes codes for various glomerular diseases, including FSGS.
Key Information: ICD-10 code for FSGS
Essential facts and insights about Focal Segmental Glomerulosclerosis
Primary ICD-10-CM Code for fsgs
Decision Criteria
clinical Criteria
- Biopsy shows segmental sclerosis and podocyte effacement.
documentation Criteria
- Documentation must specify absence of secondary causes.
Applicable To
- Biopsy-confirmed FSGS lesions
- Nephrotic syndrome with proteinuria ≥3.5 g/day
Excludes
- Secondary causes like obesity, diabetes
Clinical Validation Requirements
- Biopsy showing segmental sclerosis and podocyte effacement
- Proteinuria ≥3.5 g/day and serum albumin <3.0 g/dL
Code-Specific Risks
- Misclassification if secondary causes are not ruled out
Coding Notes
- Ensure documentation specifies primary vs. secondary FSGS.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Minimal change disease
N04.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Focal Segmental Glomerulosclerosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N04.1.
Impact
Clinical: Misdiagnosis of FSGS type, Regulatory: Non-compliance with coding standards, Financial: Potential reimbursement issues
Mitigation Strategy
Thoroughly review patient history for secondary causes.
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with ICD-10 rules, Data Quality: Inaccurate clinical data
Mitigation Strategy
Ensure secondary causes are documented and coded first.
Impact
Failure to document secondary causes can lead to audit issues.
Mitigation Strategy
Ensure all potential secondary causes are documented.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Focal Segmental Glomerulosclerosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Focal Segmental Glomerulosclerosis
Use these documentation templates to ensure complete and accurate documentation for Focal Segmental Glomerulosclerosis. These templates include all required elements for proper coding and billing.
Nephrology Progress Note
Specialty: NephrologyRequired Elements
- Biopsy findings
- Proteinuria levels
- Serum albumin levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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