E43 — Unspecified severe protein-calorie malnutrition
E43 is a billable, specific ICD-10-CM code for unspecified severe protein-calorie malnutrition. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Starvation edema
Risk adjustment
E43 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
E43 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
- A56798Billing and Coding: Vitamin D Assay Testing
- A57414Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
How E43 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E43.
- Anasarca›nutritional
- Atrophy, atrophic›nutritional
- Deficiency, deficient›calorie, severe
- Emaciation›due to malnutrition
- Malnutrition›severe(protein-energy)
- Wasting›extreme(due to malnutrition)
- Malnutrition›degree›severe(protein-energy)
- Malnutrition›degree›third
- Disease, diseased›wasting NEC›due to›malnutrition
- Malnutrition›protein›calorie›severe
- Malnutrition›protein›energy›severe
- Wasting›disease›due to›malnutrition
Questions about E43
- Is E43 a billable ICD-10-CM code?
- Yes. E43 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E43 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Malnutrition (E40-E46).