Retarded development following protein-calorie malnutrition
In Malnutrition (E40-E46), chapter 4: Endocrine, Nutritional and Metabolic Diseases
- E45 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 a CC (complication or comorbidity), 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.
- 489 US deaths in 2024 had an underlying cause in category E45, 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: Development, arrested, due to malnutrition; Dwarfism, nutritional; Dystrophy, due to malnutrition; Dystrophy, nutritional; Nutritional stunting; Retardation, growth, due to malnutrition; Retardation, physical, due to malnutrition; Stunting
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Instructional notes
Includes: conditions that are coded here
- Nutritional short stature
- Nutritional stunting
- Physical retardation due to malnutrition
Also applies, from Malnutrition (E40-E46)
These notes sit on E40-E46 and apply to every code under it, including E45.
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)
- E40Kwashiorkor
- E41Nutritional marasmus
- E42Marasmic kwashiorkor
- E43Unspecified severe protein-calorie malnutrition
- E44Protein-calorie malnutrition of moderate and mild degree
- E45Retarded development following protein-calorie malnutrition(this code)
- E46Unspecified protein-calorie malnutrition
E45 MS-DRGs
As the principal diagnosis, E45 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.
E45 is in Malnutrition (END008, its default category), with 14 codes. Others in it:
Medicare coverage articles listing E45
These 3 Medicare billing and coding articles list E45 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 E45
Notes on these codes point to E45.
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).
- 263.2 Arrested development following protein-calorie malnutrition (approximate)