Nephritic syndrome, NOS
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| ICD10 Diagnosis | |
| Dx: | Nephritic syndrome, NOS |
| ICD10 code: | N05 |
| Pre-ICD10 counterpart: | No corresponding old article |
| Charlson/ALERT Scale: | Renal disease |
| APACHE Como Component: | none |
| APACHE Acute Component: | 2019-0: Metabolic/Renal NOS, 2019-0: Renal/Metabolic NOS |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
- In ICD10 there are no codes specific for glomerulonephritis (GN) -- instead the various forms of that entity are included in the various codes for "Nephritic sydrome"
- Nephritic syndrome represents a class/category of renal diseases that are due to non-infectious inflammation of the glomerulus
- Though non-infectious, a classic cause of GN is immune-mediated and elicited by PRIOR infection by a variety of organisms, though Streptococci is the classic (so-called Post-strep GN) if using this code combine with Other specified infectious agents as the cause of diseases classified by other ICD10 code
- Although often primary, i.e. the etiology is auto-immune, there are numerous other conditions that can cause GNs (e.g. post-infectious which is an immune-mediated problem and not due to the organism itself; in association with other immune disorders such as Lupus and vasculitis; immune consequences of drug use such as iv heroin, others). When the etiology is NOT primary, combine the cause with the appropriate Nephritic syndrome code.
- Regarding the various codes for nephritic syndrome (Nephritic syndrome, acute, Nephritic syndrome, rapidly progressive, Nephritic syndrome, chronic, Nephritic syndrome, NOS)
- They include
- glomerulonephritis
- nephritis
- other inflammatory glomerular diseases
- Don't get confused, another way to classify glomerular diseases is by what they look like under the microscope (e.g. minimal change, membranous, crecentic, etc) -- but in ICD10 these are all included within all the codes for nephritic syndrome.
- They include
- The difference between the various Nephritic syndrome codes is clinical onset and persistence:
- code Nephritic syndrome, rapidly progressive if and only if the primary or renal team label it as "rapidly progressive", as in "Rapidly progressive GN"
- if acute in presentation/onset, but they don't label it as "rapidly progressive", then use Nephritic syndrome, acute
- if stated by the teams to be chronic, then use Nephritic syndrome, chronic
- if nothing is said about it's onset or persistence, then use the wastebasket of Nephritic syndrome, NOS
- Important to distinguish the various Nephritic syndrome codes from Nephrotic syndrome
- a classic cause of GN (especially Nephritic syndrome, rapidly progressive is as an immune after-effect of Strep infection, so-called Post-strep GN). To code this we will add a new code B98, to be called Other specified infectious agents as the cause of diseases classified by other ICD10 code -- this new code, with the appropriate Streptoccus code, is then combined with the appropriate Nephritic syndrome code to get Post-strep GN
Alternate ICD10s to consider coding instead or in addition
| Nephritic syndrome codes: |
Candidate Combined ICD10 codes
Infections
Infections in ICD10 have combined coding requirements for some of their pathogens. Any that have antibiotic resistances would store those as Combined ICD10 codes as well. If the infection is acquired in the hospital, see Nosocomial infection, NOS. See Lab and culture reports for confirmation and details about tests. See Infections in ICD10 for more general info.
Possible Simultaneous Presence of Multiple Different Types of Infection in a Single Site
- This refers to the situation where there may be simultaneous infection with multiple types of organisms -- e.g. 2 of bacteria, virus, fungus. While a classic example is a proven viral pneumonia (e.g. influenza) with a suspected/possible bacterial pneumonia superimposed, this kind of thing can occur in places other than the lungs, e.g. meningitis.
- The "signature" of this is typically the patient being treated simultaneously with antimicrobial agents for multiple types of organisms. BUT don't confuse this with there being infections at DIFFERENT body sites.
- As per our usual practice, we will consider a diagnosis as present if the clinical team thinks it's present and are treating it, with the exception that the team initially treated for the possible 2nd type of infection but then decided it likely was NOT present and stopped those agents.
- And remember that Infectious organism, unknown is used when the the specific organism is unknown (this could be not knowing the TYPE of organism, or suspecting the type but not having identified the specific organism of that type), while when the organism has been identified but it's not in our bug list, THEN use Bacteria, NOS, Virus, NOS or Fungus or yeast, NOS.
Attribution of infections
Related CCI Codes
Data Integrity Checks (automatic list)
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