FY2027 ICD-10-CM reference
E43: Unspecified severe protein-calorie malnutrition
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Unspecified severe protein-calorie malnutrition. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
CMS-HCC V28
No V28 HCC for 2026 dates of service (CMS 2027 Initial ICD-10-CM Mappings)
CMS-HCC V24
Not used for payment year 2027 Medicare Advantage payment
ESRD
- HCC 21: Protein-Calorie Malnutrition
Coefficient pending: payment year 2027 coefficients for this model are not yet verified, so no RAF is shown. Mapping: PY2026 CMS mapping; CMS 2027 initial file unchanged.
PACE
Source verification pending
RxHCC
No category in the PY2026 CMS mapping; CMS 2027 initial file unchanged
HHS-HCC
- HCC 23: Protein-Calorie Malnutrition
RAF not applicable: HHS-HCC weights vary by metal level. Mapping: HHS-HCC 2026 benefit year.
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Source: E00-E89 (chapter, inherited).
Excludes1
transitory endocrine and metabolic disorders specific to newborn (P70-P74)
Source: E00-E89 (chapter, inherited).
Excludes1
intestinal malabsorption (K90.-)
Source: E40-E46 (section, inherited).
Excludes1
sequelae of protein-calorie malnutrition (E64.0)
Source: E40-E46 (section, inherited).
Excludes2
nutritional anemias (D50-D53)
Source: E40-E46 (section, inherited).
Excludes2
starvation (T73.0)
Source: E40-E46 (section, inherited).
Instructional note
Starvation edema
Source: E43 (category, direct).
Compare the FY2027 additions, removals and billable-status changes
What does E43 mean in FY2027?
The official ICD-10-CM descriptor is Unspecified severe protein-calorie malnutrition. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is E43 billable in FY2027?
The FY2027 order file marks E43 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does E43 map to an HCC?
E43 has no CMS-HCC V28 category in the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service). Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: ESRD HCC 21; no RxHCC category. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: HCC 23 under the HHS-HCC 2026 benefit year mapping (no RAF; HHS-HCC weights vary by metal level). CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition