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ICD-10 Guide
ICD-10 CodesE64.0

E64.0

Billable

Sequelae of protein-calorie malnutrition

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E64.0 is a billable code used to indicate a diagnosis of sequelae of protein-calorie malnutrition.

Key Diagnostic Point:

Sequelae of protein-calorie malnutrition refers to the long-term effects and complications that arise from inadequate intake of protein and calories over an extended period. This condition often results from chronic illnesses, socioeconomic factors, or inadequate dietary intake. Patients may experience a range of sequelae, including muscle wasting, impaired immune function, and delayed wound healing. Long-term malnutrition can lead to significant health issues such as osteoporosis, anemia, and increased susceptibility to infections. The sequelae can manifest as physical, cognitive, and psychological impairments, affecting the overall quality of life. Clinicians must assess the patient's nutritional status and history to identify these sequelae accurately. Management typically involves nutritional rehabilitation, addressing underlying causes, and monitoring for complications. Understanding the long-term implications of protein-calorie malnutrition is crucial for effective patient care and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of nutritional deficiencies and their long-term effects.
  • Differentiation from other malnutrition-related codes.
  • Need for comprehensive patient history and documentation.
  • Potential overlap with other chronic conditions.

Audit Risk Factors

  • Inadequate documentation of nutritional assessments.
  • Failure to link sequelae to the underlying malnutrition.
  • Misclassification of malnutrition severity.
  • Lack of follow-up documentation on treatment outcomes.

Specialty Focus

Medical Specialties

Nutrition and Dietetics

Documentation Requirements

Detailed dietary history, assessment of nutritional status, and treatment plans.

Common Clinical Scenarios

Patients with chronic illnesses requiring dietary management, elderly patients with weight loss.

Billing Considerations

Ensure accurate documentation of dietary intake and nutritional interventions.

Internal Medicine

Documentation Requirements

Comprehensive medical history, physical examination findings, and lab results.

Common Clinical Scenarios

Patients presenting with unexplained weight loss, fatigue, or recurrent infections.

Billing Considerations

Document any underlying conditions contributing to malnutrition.

Coding Guidelines

Inclusion Criteria

Use E64.0 When
  • According to ICD
  • 10 guidelines, E64
  • 0 should be used when there is clear documentation of sequelae resulting from protein
  • calorie malnutrition
  • It is important to ensure that the underlying cause of malnutrition is also documented, as this may affect coding and reimbursement

Exclusion Criteria

Do NOT use E64.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97802CPT Code

Medical nutrition therapy, individual, face-to-face

Clinical Scenario

Used for patients receiving nutritional counseling for malnutrition.

Documentation Requirements

Document the patient's nutritional assessment and treatment plan.

Specialty Considerations

Nutrition specialists should ensure comprehensive documentation of dietary interventions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malnutrition sequelae, improving the accuracy of patient records and reimbursement processes. E64.0 provides a clear distinction between acute and chronic conditions, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malnutrition sequelae, improving the accuracy of patient records and reimbursement processes. E64.0 provides a clear distinction between acute and chronic conditions, facilitating better patient management.

Reimbursement & Billing Impact

reimbursement processes. E64.0 provides a clear distinction between acute and chronic conditions, facilitating better patient management.

Resources

Clinical References

  • •
    Nutrition and Malnutrition: A Guide for Healthcare Professionals

Coding & Billing References

  • •
    Nutrition and Malnutrition: A Guide for Healthcare Professionals

Frequently Asked Questions

What are the common sequelae of protein-calorie malnutrition?

Common sequelae include muscle wasting, impaired immune function, anemia, osteoporosis, and cognitive decline. These effects can significantly impact a patient's quality of life and overall health.