All ICD10 Codes
E41Billable, valid for claims from October 1, 2026

Nutritional marasmus

In Malnutrition (E40-E46), chapter 4: Endocrine, Nutritional and Metabolic Diseases

  • E41 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.
  • 177 US deaths in 2024 had an underlying cause in category E41, per the National Vital Statistics System on CDC WONDER. Death records use WHO ICD-10, so the count is for the whole category.

Also indexed as: Athrepsia; Atrophy, infantile; Atrophy, nutritional, with marasmus; Deficiency, calorie, severe, with marasmus; Disease, wasting NEC, due to, malnutrition, with marasmus; Malnutrition, degree, severe, with, marasmus; Malnutrition, protein, calorie, severe, with, marasmus; Malnutrition, protein, energy, severe, with, marasmus; Malnutrition, severe, intermediate form, marasmus; Marasmus; Marasmus, due to malnutrition; Marasmus, intestinal; Marasmus, nutritional; Pedatrophia; Wasting, disease, due to, malnutrition, with marasmus; Wasting, extreme, with marasmus

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Instructional notes

Includes: conditions that are coded here

  • Severe malnutrition with marasmus

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 E41.

Excludes1: not coded here, use a different code

  • intestinal malabsorption (K90.-)
  • sequelae of protein-calorie malnutrition (E64.0)

Excludes2: not included here, code separately if applicable

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.

Read Section I.C.4 (page 39)

Other codes under E40-E46

Malnutrition (E40-E46)

E41 MS-DRGs

As the principal diagnosis, E41 groups to MS-DRG 640, 641, 791, or 793 (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.

E41 is in Malnutrition (END008, its default category), with 14 codes. Others in it:

  • E40 Kwashiorkor
  • 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 E41

These 8 Medicare billing and coding articles list E41 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 E41

Notes on these codes point to E41.

  • E88.A Excludes1: nutritional marasmus (E41)
  • R64 Excludes1: nutritional marasmus (E41)

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 MedlinePlus

Code 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).

  • 261 Nutritional marasmus (approximate)
ICD-9 to ICD-10 converter