Q&A: Documentation and ICD-10-CM coding for severe malnutrition
Moderate (stage 1) malnutrition | Moderate (stage 1) malnutrition | Severe (stage 2) malnutrition |
Weight loss % (unintended) | 5%–10% < 6 months, or 10%–20% > 6 months | > 10% < 6 months, or > 20% > 6 months |
Low BMI | < 20 if < 70 years, or < 22 if > 70 year ... | < 18.5 if < 70 years, or < 20 if > 70 ye ... |
Reduced muscle mass | Mild-to-moderate deficit (per validated ... | Severe deficit (per validated assessment ... |
Coding professionals would use ICD-10-CM code E43 to report severe malnutrition, also known as starvation edema.
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.
Energy intake: less than (<) 50% estimates energy requirement for greater than (>) 5 days Coding professionals would use ICD-10-CM code E43 to report severe malnutrition, also known as starvation edema.
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.
Malnutrition ICD-10-CM Code range E40-E46.
There are 4 broad sub-forms of undernutrition: wasting, stunting, underweight, and deficiencies in vitamins and minerals.
E44.00.
The main diagnostic features are:weight-for-length/height < -3SD (wasted) or.mid-upper arm circumference < 115 mm or.oedema of both feet (kwashiorkor with or without severe wasting).
Malnutrition is often split into two broad groups of conditions:undernutrition, including stunting, wasting, underweight and micronutrient deficiencies.overweight, obesity and diet-related non-communicable diseases (NCDs).
Classification of Malnutrition in ChildrenClassificationDefinitionGradingWHO (wasting)z-scores (SD) below median WFHModerate SevereWHO (stunting)z-scores (SD) below median HFAModerate SevereKanawatiMUAC divided by occipitofrontal head circumferenceMild Moderate SevereColez-scores of BMI for ageGrade 1 Grade 2 Grade 32 more rows•Jul 20, 2010
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.
Moderate malnutrition (MM) is defined as a weight-for-age between -3 and -2 z-scores below the median of the WHO child growth standards. It can be due to a low weight-for-height (wasting) or a low height-for-age (stunting) or to a combination of both.
Documentation of malnutritionInsufficient energy intake.Weight loss.Loss of muscle mass.Loss of subcutaneous fat.Localized or generalized fluid accumulation that can mask weight loss.Decreased functional status as measured by hand grip strength device.
MAM is defined as MUAC < 12.5 cm, but ≥ 11.5 cm. Non-complicated SAM will be defined as MUAC < 11.5 cm, or + or ++ bilateral edema, and having an acceptable appetite. An acceptable appetite will be judged by giving the child 30 g of RUTF and asking the mother to feed this food to the child over 20 minutes.
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.
The percentage of children stunted, wasted, and underweight are equal to the specific numerators divided by the appropriate denominators and multiplied by 100. The mean z-scores are equal to the numerator divided by the appropriate denominator.
Malnutrition refers to deficiencies, excesses or imbalances in a person's intake of energy and/or nutrients.
Micronutrient malnutritionMicronutrient malnutrition Worldwide, deficiencies in iodine, Vitamin A, and iron are the most common.
Malnutrition occurs when a person's diet lacks sufficient nutrients. Malnutrition is a condition that occurs when a person does not consume a well balanced diet. The diseases which are caused due to a lack of nutrients in the diet are called Deficiency Diseases.
Primary malnutrition is particularly prevalent in poor communities such as marginalised rural villages, urban squatter camps and refugee camps. Secondary malnutrition may occur in people whose food intake is disturbed because of poor appetite or faulty digestion, absorption or use of nutrients in the body.
Chronic disease, or acute disease/injury with severe systemic inflammation, or socio-economic/environmental starvation. Under the new criteria, severity of malnutrition is based on phenotypic criteria only, and requires one phenotypic criterion that meets these thresholds: Moderate (stage 1) malnutrition. Severe (stage 2) 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 followed in the U.S.
Cancer and cancer treatment may cause malnutrition. An imbalanced nutritional status resulted from insufficient intake of nutrients to meet normal physiological requirement.
Malnutrition, not enough calories in diet. Nutritional disorder. Protein calorie malnutrition. Protein-calorie malnutrition with hypoalbuminemia. Clinical Information. A condition caused by not getting enough calories or the right amount of key nutrients, such as vitamins and minerals, that are needed for health.