E40-E46
Medium Complexity

Malnutrition

Primary Specialty: Dietetics
Last Updated: 2025-09-09

ICD-10 Codes (8)

8 billable
0 category headers
E41
Billable
Nutritional marasmus
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E42
Billable
Marasmic kwashiorkor
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E43
Billable
Unspecified severe protein-calorie malnutrition
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E44
Billable
Protein-calorie malnutrition of moderate and mild degree
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E44.0
Billable
Moderate protein-calorie malnutrition
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E44.1
Billable
Mild protein-calorie malnutrition
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E45
Billable
Retarded development following protein-calorie malnutrition
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E46
Billable
Unspecified protein-calorie malnutrition
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Updates & Changes

FY 2026 Updates

Current Year

Deleted Codes

No codes deleted in this range for FY 2026

No significant changes for FY 2026

This range maintains stability with current coding practices

Historical Changes

  • FY 2025: Routine maintenance updates with minor terminology clarifications
  • FY 2024: Enhanced specificity requirements for certain code ranges
  • FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

  • Proposed updates pending review by Coordination and Maintenance Committee
  • Under consideration: Enhanced digital health integration codes

Implementation Guidance

  • Review all FY 2026 updates for E40-E46 codes before implementation
  • Always verify the most current codes in the ICD-10-CM manual
  • Ensure clinical documentation supports the selected diagnosis codes
  • +3 more guidance items...

Range Overview

high priority

The ICD-10 code range E40-E46 is dedicated to malnutrition, a condition characterized by inadequate intake or absorption of nutrients. This range includes codes for various types of malnutrition, such as kwashiorkor, marasmus, and nutritional stunting. These codes are used to document the severity and type of malnutrition, which is crucial for treatment planning and monitoring patient progress.

Key Usage Points:

  • E40-E46 codes are used to document all types of malnutrition, from mild to severe.
  • The specific type of malnutrition (e.g., kwashiorkor, marasmus) should be coded when known.
  • Severity of malnutrition (mild, moderate, severe) should be documented and coded.
  • E46, Unspecified protein-calorie malnutrition, is used when the type or severity of malnutrition is not specified.
  • E43, Unspecified severe protein-calorie malnutrition, is used when the patient has severe malnutrition, but the specific type is unknown.

Coding Guidelines

When to Use:

  • When a patient is diagnosed with a specific type of malnutrition.
  • When a patient is diagnosed with malnutrition of a specific severity.
  • When a patient is diagnosed with malnutrition, but the type or severity is unknown.
  • When malnutrition is a contributing factor to another health condition.
  • When malnutrition is the primary reason for a patient's visit.

When NOT to Use:

  • When a patient is at risk for malnutrition but has not been diagnosed.
  • When a patient has a nutritional deficiency, but not malnutrition.
  • When a patient has an eating disorder, but not malnutrition.
  • When a patient is overweight or obese.

Code Exclusions

Always verify exclusions with the patient's medical record and the latest ICD-10 guidelines.

Documentation Requirements

Documentation for malnutrition should include the type and severity of malnutrition, if known. The cause of malnutrition, if identified, should also be documented. Any related conditions or complications should be noted.

Clinical Information:

  • Type of malnutrition
  • Severity of malnutrition
  • Cause of malnutrition
  • Related conditions or complications
  • Treatment plan

Supporting Evidence:

  • Lab results
  • Dietary history
  • Physical exam findings
  • Nutritionist's assessment
Good Documentation Example:

Patient diagnosed with severe marasmus due to chronic malabsorption. Lab results show low protein levels. Treatment plan includes high-protein diet and nutritional supplements.

Poor Documentation Example:

Patient has malnutrition.

Common Documentation Errors:

  • Not specifying the type or severity of malnutrition
  • Not documenting the cause of malnutrition
  • Not noting related conditions or complications

Range Statistics

7
Total Codes
8
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:4

Coding Complexity

Medium
Complexity Rating

Coding for malnutrition is of medium complexity due to the need to accurately document the type and severity of malnutrition, identify the cause, and code any related conditions or complications. Additionally, coders must be aware of exclusions to avoid incorrect coding.

Key Factors:
  • Determining the type and severity of malnutrition
  • Identifying the cause of malnutrition
  • Coding related conditions or complications
  • Navigating exclusions

Specialty Focus

Malnutrition codes are primarily used by dietitians, gastroenterologists, and primary care physicians. They are also used in hospital settings to document the nutritional status of patients.

Primary Specialties:
Dietetics
40%
Gastroenterology
30%
Primary Care
30%
Clinical Scenarios:
  • A patient with Crohn's disease has severe weight loss and is diagnosed with marasmus.
  • A child with failure to thrive is diagnosed with nutritional stunting.
  • A patient with anorexia nervosa is diagnosed with severe protein-calorie malnutrition.
  • A patient with cancer is diagnosed with moderate malnutrition due to decreased appetite.
  • A patient with kwashiorkor due to a severely restricted diet.

Resources & References

Resources for coding malnutrition include the ICD-10-CM Official Guidelines for Coding and Reporting, the American Dietetic Association's Guide to Nutrition Care, and the World Health Organization's guidelines on malnutrition.

Official Guidelines:

  • ICD-10-CM Official Guidelines for Coding and Reporting
  • American Dietetic Association's Guide to Nutrition Care
  • World Health Organization's guidelines on malnutrition

Clinical References:

  • American Journal of Clinical Nutrition
  • Journal of the Academy of Nutrition and Dietetics

Educational Materials:

  • American Health Information Management Association's ICD-10 training materials
  • American Academy of Professional Coders' ICD-10 resources

Frequently Asked Questions

How do I code for malnutrition if the type or severity is not specified?

If the type of malnutrition is not specified, use E46 for Unspecified protein-calorie malnutrition. If the patient has severe malnutrition but the type is unknown, use E43 for Unspecified severe protein-calorie malnutrition.