2025 ICD-10-CM code E43
(Valid) Effective Date: N/A Nutritional Deficiencies - Malnutrition 4 Endocrine, Nutritional and Metabolic Diseases Feed
Severe protein-calorie malnutrition, unspecified.
Medical necessity for treatment of severe protein-calorie malnutrition is established by the presence of significant protein and calorie deficiency, evidenced by clinical findings and laboratory results.Treatment is necessary to restore nutritional balance, prevent further complications, and improve overall health and well-being.
Clinicians diagnose severe PCM based on the patient’s history, signs and symptoms, and physical examination. Laboratory tests include blood and urine tests to measure protein and blood glucose levels. Imaging tests, such as an abdominal ultrasound, may be used to detect liver enlargement. Other tests include calculating the body mass index (BMI), skin biopsy, and hair analysis. Treatment depends on symptom severity and may include a protein-rich diet and vitamin supplements; severe cases require hospitalization to treat dehydration, low blood glucose, anemia, and infection. Severe anemia is treated with blood transfusions, and infections are treated with antibiotics.
In simple words: Severe protein-calorie malnutrition is a serious condition where a person hasn't gotten enough protein and calories for a long time, leading to significant muscle loss and very little body fat.It can happen when someone doesn't eat enough, or it can be related to other health problems like cancer.
Unspecified severe protein–calorie malnutrition (PCM) refers to a severe type of malnutrition characterized by severe muscle wasting and loss of subcutaneous fat. It is primarily caused by insufficient intake of nutrition, less than 50 percent of the required amount for more than 2 weeks. It may also affect patients suffering from cancer or undergoing cancer treatment and bedridden patients. The provider does not specify the type and level of severe PCM.
Example 1: A child in a developing country with inadequate food resources presents with severe wasting, edema, and growth retardation. The child's diet history reveals a significant lack of protein and calories., A patient undergoing cancer treatment experiences severe nausea and vomiting, leading to inadequate nutritional intake and subsequent severe protein-calorie malnutrition., A bedridden elderly patient with limited mobility and access to food develops severe muscle wasting and fat loss due to prolonged inadequate nutrition.
Documentation should include details of the patient's nutritional history, physical examination findings (e.g., muscle wasting, edema, growth retardation), laboratory results (e.g., protein and glucose levels), and any associated conditions (e.g., cancer, infection).
- Payment Status: Active
- Specialties:Internal Medicine, Pediatrics, Family Medicine, Oncology, Geriatrics
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Home, Skilled Nursing Facility, Nursing Facility