ICD-10 N05
Non-Billable HeaderUnspecified nephritic syndrome
About ICD-10-CM N05
ICD-10-CM code N05 represents Unspecified nephritic syndrome. This is a non-billable header code in the Genitourinary System chapter (block N05). The 2026 edition of ICD-10-CM N05 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with N05. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- nephropathy NOS with no stated morphological lesion (N28.9)
- renal disease NOS with no stated morphological lesion (N28.9)
- tubulo-interstitial nephritis NOS (N12)
Includes
- glomerular disease NOS
- glomerulonephritis NOS
- nephritis NOS
- nephropathy NOS and renal disease NOS with morphological lesion specified in .0-.8
Medicare LCD Coverage for N05
Local Coverage Determinations (LCDs) from CMS MACs that list N05 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing N05.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but N05 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with N05
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To N05
Other codes in section N00-N08 (Glomerular diseases).
ICD-10 N05, Billing FAQ
Is ICD-10 code N05 billable? +
No, N05 is a non-billable header code. Use a more specific child code from block N05 when submitting claims.
What codes are Type 1 Excludes for N05? +
Type 1 Excludes (never code together with N05): nephropathy NOS with no stated morphological lesion (N28.9); renal disease NOS with no stated morphological lesion (N28.9); tubulo-interstitial nephritis NOS (N12)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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