Kwashiorkor
In Malnutrition (E40-E46), chapter 4: Endocrine, Nutritional and Metabolic Diseases
- E40 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under E40-E46 below.
- As a secondary diagnosis it is an MCC (major complication), which can raise the MS-DRG payment. It doesn't count when the principal diagnosis is one of 9 closely related codes.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28; it was HCC 21 in V24).
- AHRQ's Chronic Condition Indicator classes it as chronic: expected to last 12 months or longer and to limit daily life or need ongoing care.
Also indexed as: Edema, nutritional, with dyspigmentation, skin and hair; Kwashiorkor; Malnutrition, degree, severe, with, kwashiorkor; Malnutrition, malignant; Malnutrition, protein, calorie, severe, with, kwashiorkor; Malnutrition, protein, energy, severe, with, kwashiorkor; Malnutrition, severe, with, kwashiorkor; Pluricarential syndrome of infancy; Polycarential syndrome of infancy; Syndrome, pluricarential of infancy; Syndrome, plurideficiency; Syndrome, polycarential of infancy
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Instructional notes
Includes: conditions that are coded here
- Severe malnutrition with nutritional edema with dyspigmentation of skin and hair
Excludes1: not coded here, use a different code
- marasmic kwashiorkor (E42)
Also applies, from Malnutrition (E40-E46)
These notes sit on E40-E46 and apply to every code under it, including E40.
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers diabetes mellitus coding, including type, insulin and drug use, pump malfunction and secondary diabetes, plus obesity and obesity class codes.
- Diabetes mellitus (page 39)
- Obesity (page 42)
Other codes under E40-E46
Malnutrition (E40-E46)
E40 MS-DRGs
As the principal diagnosis, E40 groups to MS-DRG 640 or 641 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
E40 is in Malnutrition (END008, its default category), with 14 codes. Others in it:
- E41 Nutritional marasmus
- E42 Marasmic kwashiorkor
- E43 Unspecified severe protein-calorie malnutrition
- E44.0 Moderate protein-calorie malnutrition
- E44.1 Mild protein-calorie malnutrition
- E45 Retarded development following protein-calorie malnutrition
- E46 Unspecified protein-calorie malnutrition
- O25.10 Malnutrition in pregnancy, unspecified trimester
Medicare coverage articles listing E40
These 3 Medicare billing and coding articles list E40 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
Other codes that refer to E40
Notes on these codes point to E40.
- E08 Code First: malnutrition (E40-E46)
- G63 Code First: nutritional deficiency (E40-E64)
- H28 Code First: protein-calorie malnutrition (E40-E46)
- P00.4 Includes: Newborn affected by maternal disorders classifiable to E40-E64
- R60.1 Excludes2: nutritional edema (E40-E46)
- R63.31 Code Also: malnutrition (E40-E46)
- R63.32 Code Also: malnutrition (E40-E46)
- R63.6 Excludes1: malnutrition (E40-E46)
- Z59.4 Excludes2: malnutrition (E40-E46)
- Z72.4 Excludes1: malnutrition and other nutritional deficiencies (E40-E64)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Malnutrition
Malnutrition means that your body isn't getting enough calories or the right balance of nutrients to stay healthy. This can happen if you don't get enough protein, carbohydrates, and fats, eat too much unhealthy food, or don't get the vitamins and minerals your body needs.
Read more about malnutrition on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 260 Kwashiorkor (approximate)