If the physician documents moderate-severe malnutrition, coders or CDI specialists should query to determine which of these apply. If the answer is "severe," assign code 261 (nutritional marasmus). If the answer is "moderate," assign code 263.0 (malnutrition of moderate degree). See Coding Clinic, Third Quarter 2012, p. 10.
Sequelae of unspecified nutritional deficiency
While ICD-9-CM classified cachexia due to malnutrition as only 799.4, many coders may add an additional code for the documented malnutrition. Auditors may challenge this because the index classifies cachexia due to malnutrition as 799.4, and does not explicitly allow for the addition of a malnutrition code, Kennedy says.
Malnutrition ICD-10-CM Code range E40-E46.
Code 261 also includes severe calorie deficiency and severe malnutrition, not otherwise specified. 262, Other severe protein-calorie malnutrition — includes nutritional edema without mention of dyspigmentation of the skin and hair.
E44.00.
Severe Protein Calorie Malnutrition (>2 of the following characteristics) • Obvious significant muscle wasting, loss of subcutaneous fat. • Nutritional intake of < 50% of recommended intake for 2 weeks or more (as assessed by dietitian).
ICD-10-CM Code for Anorexia R63.
Coding Clinic Fourth Quarter 1989 advised the sequencing of code 307.1, Anorexia nervosa, as principal diagnosis for anorexia with severe malnutrition since anorexia implies malnutrition.
Coding professionals would use ICD-10-CM code E43 to report severe malnutrition, also known as starvation edema. They would use ICD-10-CM code E42 to report severe protein-calorie malnutrition with signs of both kwashiorkor and marasmus.
Protein-Calorie Malnutrition (PCM) refers to a nutritional status in which reduced availability of nutrients leads to changes in body composition and function [1].
The top five ranked criteria included three phenotypic criteria (weight loss, low body mass index, and reduced muscle mass) and two etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden).
Protein-calorie malnutrition (PCM) (also called protein-energy malnutrition or PEM) occurs when a child doesn't eat enough protein and energy (measured by calories) to meet nutritional needs.
Moderate malnutrition is defined as a weight for height z score between 2 and 3 standard deviations (SD) below the mean. 8 Severe malnutrition is defined as the weight for height z score more than 3 SD below the mean, or an arm circumference <110 mm, or the presence of nutritional oedema.
19, however, states that a BMI documented by a dietician cannot be coded unless the provider documents a nutritionally-related diagnosis, such as obesity, overweight, underweight, or malnutrition, Kennedy says. These affirm that the BMI code meets the guidelines' definition of an additional diagnosis.
From a coding perspective, GLIM identifies only moderate and severe malnutrition. Malnutrition stage is not an indexed term, so if Stage 1 is documented, code E46 (unspecified malnutrition) may be used. If only Stage 2 is documented, it must be clarified as severe for correct coding of the condition. At this time, the ASPEN criteria are still being ...
Coding professionals would use ICD-10-CM code E43 to report severe malnutrition, also known as starvation edema. They would use ICD-10-CM code E42 to report severe protein-calorie malnutrition with signs of both kwashiorkor and marasmus.
Under the new criteria, severity of malnutrition is based on phenotypic criteria only, and requires one phenotypic criterion that meets these thresholds: