Niacin deficiency [pellagra]
In Other nutritional deficiencies (E50-E64), chapter 4: Endocrine, Nutritional and Metabolic Diseases
- E52 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under E50-E64 below.
- As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
Also indexed as: Acid, deficiency, amide nicotinic; Acid, deficiency, nicotinic; Alcohol, pellagra; Avitaminosis, B, with, pellagra; Avitaminosis, nicotinic acid; Cheilosis, with pellagra; Deficiency, niacin; Deficiency, nicotinamide; Deficiency, nicotinic acid; Deficiency, vitamin NOS, B NOS, with, pellagra; Deficiency, vitamin NOS, nicotinic; Deficiency, vitamin NOS, PP; Dementia), in, niacin deficiency; Dementia), in, niacin deficiency, with behavioral disturbance; Dementia), in, pellagra; Dementia), in, pellagra, with behavioral disturbance; Dermatitis, pellagrous; Encephalopathy, pellagrous; Erythema, endemic; Gingivitis, pellagrous; Glossitis, pellagrous; Niacin deficiency; Nicotinic acid deficiency; Pellagra; Pellagra, with, polyneuropathy; Polioencephalopathy, with, pellagra; Polyneuropathy, in, pellagra; Syndrome, pellagroid
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Instructional notes
Includes: conditions that are coded here
- Niacin (-tryptophan) deficiency
- Nicotinamide deficiency
- Pellagra (alcoholic)
Excludes1: not coded here, use a different code
- sequelae of niacin deficiency (E64.8)
Also applies, from Other nutritional deficiencies (E50-E64)
These notes sit on E50-E64 and apply to every code under it, including E52.
Excludes2: not included here, code separately if applicable
- nutritional anemias (D50-D53)
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 E50-E64
Other nutritional deficiencies (E50-E64)
- E50Vitamin A deficiency
- E51Thiamine deficiency
- E52Niacin deficiency [pellagra](this code)
- E53Deficiency of other B group vitamins
- E54Ascorbic acid deficiency
- E55Vitamin D deficiency
- E56Other vitamin deficiencies
- E58Dietary calcium deficiency
- E59Dietary selenium deficiency
- E60Dietary zinc deficiency
- E61Deficiency of other nutrient elements
- E63Other nutritional deficiencies
- E64Sequelae of malnutrition and other nutritional deficiencies
E52 MS-DRGs
As the principal diagnosis, E52 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.
E52 is in Nutritional deficiencies (END007, its default category), with 44 codes. Others in it:
- E50.0 Vitamin A deficiency with conjunctival xerosis
- E50.1 Vitamin A deficiency with Bitot's spot and conjunctival xerosis
- E50.2 Vitamin A deficiency with corneal xerosis
- E50.3 Vitamin A deficiency with corneal ulceration and xerosis
- E50.4 Vitamin A deficiency with keratomalacia
- E50.5 Vitamin A deficiency with night blindness
- E50.6 Vitamin A deficiency with xerophthalmic scars of cornea
- E50.7 Other ocular manifestations of vitamin A deficiency
Medicare coverage articles listing E52
These 4 Medicare billing and coding articles list E52 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.
- Routine Foot Care (4 contractors)
- Routine Foot Care and Debridement of Nails (2 contractors)
- Electrocardiograms
- Foot Care
Other codes that refer to E52
Notes on these codes point to E52.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
B Vitamins
The B vitamins are: These vitamins help the process your body uses to get or make energy from the food you eat. They also help form red blood cells. You can get B vitamins from proteins such as fish, poultry, meat, eggs, and dairy products. Leafy green vegetables, beans, and peas also have B vitamins. Many cereals and some breads have added B vitamins.
Read more about b vitamins on MedlinePlusMalnutrition
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).
- 265.2 Pellagra