E41

HCC Category Mapping

What This Code Means

Severe malnutrition caused by inadequate calories and protein, resulting in extreme weight loss and muscle wasting without significant edema.

Coding Tips

• •Marasmus presents with severe wasting but typically without edema, distinguishing it from kwashiorkor
• •Often seen in infants and young children in resource-limited settings

Clinical Significance

Nutritional marasmus represents severe total calorie and protein deficiency resulting in extreme wasting of body fat and muscle mass, typically without significant edema. Patients present with emaciated appearance, loss of subcutaneous fat, muscle atrophy, and a characteristic aged or wizened facial appearance. This condition is life-threatening and carries high mortality without appropriate nutritional rehabilitation.

Documentation Requirements

• ✓Documentation must describe severe wasting with loss of subcutaneous fat and muscle mass, body mass index or weight-for-height measurements, serum albumin and prealbumin levels, and the absence of significant peripheral edema (which would suggest kwashiorkor).
• ✓The underlying cause, nutritional assessment, and treatment plan including caloric goals should be documented.
• ✓Complications such as hypothermia, hypoglycemia, and infection should be noted.

Commonly Confused Codes