Certified Risk Adjustment Coder (CRC)

What ICD-10-CM code is reported for a diagnosis of severe malnutrition?

1. E40 (Kwashiorkor)

2. E42 (Marasmic Kwashiorkor)

3. E43 (Unspecified severe protein-calorie malnutrition)

4. E44.0 (Protein-calorie malnutrition of moderate and mild degree)

The correct answer is: E43 (Unspecified severe protein-calorie malnutrition)

The diagnosis of severe malnutrition is best represented by the ICD-10-CM code for unspecified severe protein-calorie malnutrition, which is appropriate for cases where there is a significant deficiency of energy and nutrients, but the specific type hasn't been determined. This code captures the severity of malnutrition without identifying a specific cause such as kwashiorkor or marasmus, which are more specific forms of malnutrition covered by other codes. In contrast, the codes representing specific forms of malnutrition, such as kwashiorkor and marasmic kwashiorkor, detail particular underlying nutritional deficiencies and conditions that may not fit all cases of severe malnutrition. Therefore, while those codes are valuable for specific diagnoses related to protein-calorie deficiencies, they do not encompass the broader category of severe malnutrition without further specification regarding type. The code for moderate and mild degrees of malnutrition also does not apply in this scenario, as the question specifically addresses severe malnutrition.