Practice Consideration
Example of Country Specific Use of ICD-10 Malnutrition Diagnoses
Country specific guidelines for assigning the International Classification of Diseases (ICD) code for Malnutrition may vary from the criteria used for a Nutrition Diagnosis of malnutrition. Not all countries and health-care systems allow non-physicians to assign ICD codes; however the dietitian may still choose malnutrition as a Nutrition Diagnosis using the Signs and Symptoms included in the eNCPT.(1)
» In Australia, a diagnosis of malnutrition can be documented in accordance with the ICD, by an accredited practising dietitian, providing he or she follows the correct protocol(2)
» The minimum BMI threshold calling for a diagnosis of malnutrition is BMI <18.5 kg/m2. If the patient’s BMI falls below that threshold and the patient is assessed as being malnourished, there are other factors that must be recorded: the degree of unintended weight loss, the energy intake, and the degree of fat and muscle loss.
» The ICD-10-AM Sixth Edition(2) specifies the following malnutrition diagnosis codes:
References
1. Academy of Nutrition and Dietetics. Nutrition terminology reference manual (eNCPT): Dietetics language for nutrition care. 2015; Accessed 26 September 2017. Available from: www.ncpt.webauthor.com
2. National Centre for Classification in Health. Australian coding standards for I.C.D-10-A.M. Sydney: National Centre for Classification in Health; 2008.
» In Australia, a diagnosis of malnutrition can be documented in accordance with the ICD, by an accredited practising dietitian, providing he or she follows the correct protocol(2)
» The minimum BMI threshold calling for a diagnosis of malnutrition is BMI <18.5 kg/m2. If the patient’s BMI falls below that threshold and the patient is assessed as being malnourished, there are other factors that must be recorded: the degree of unintended weight loss, the energy intake, and the degree of fat and muscle loss.
» The ICD-10-AM Sixth Edition(2) specifies the following malnutrition diagnosis codes:
E43 Unspecified severe protein-energy malnutrition
In adults, a BMI of <18.5 kg/m2 or unintentional weight loss (≥ 10%), with evidence of suboptimal energy intake, resulting in severe loss of subcutaneous fat and/or severe muscle wasting
E44 Protein-energy malnutrition of moderate and mild degree
In adults, a BMI of <18.5 kg/m2 or unintentional weight loss (5 to 9%), with evidence of suboptimal energy intake, resulting in moderate loss of subcutaneous fat and/or moderate muscle wasting
In adults, a BMI of <18.5 kg/m2 or unintentional weight loss (≥ 10%), with evidence of suboptimal energy intake, resulting in severe loss of subcutaneous fat and/or severe muscle wasting
E44 Protein-energy malnutrition of moderate and mild degree
In adults, a BMI of <18.5 kg/m2 or unintentional weight loss (5 to 9%), with evidence of suboptimal energy intake, resulting in moderate loss of subcutaneous fat and/or moderate muscle wasting
References
1. Academy of Nutrition and Dietetics. Nutrition terminology reference manual (eNCPT): Dietetics language for nutrition care. 2015; Accessed 26 September 2017. Available from: www.ncpt.webauthor.com
2. National Centre for Classification in Health. Australian coding standards for I.C.D-10-A.M. Sydney: National Centre for Classification in Health; 2008.
Updated October 11, 2020