2026 ICD-10-CM Diagnosis Code E42Marasmic kwashiorkor
ICD-10-CM Codes›E00–E89›E40-E46›E42
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Chronic Condition
E42 is a billable ICD-10-CM diagnosis code for marasmic kwashiorkor. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 640 through 641. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 9 closely related codes. Coders also document this condition as kwashiorkor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Malnutrition.
E42 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 21 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 21, ESRD (V21) category 21, and ESRD (V24) category 21 for payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
E42 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Kwashiorkor
- Marasmic kwashiorkor
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Intermediate form severe protein-calorie malnutrition
- Severe protein-calorie malnutrition with signs of both kwashiorkor and marasmus
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Kwashiorkor
a syndrome produced by severe protein deficiency, characterized by retarded growth, changes in skin and hair pigment, edema, and pathologic changes in the liver, including fatty infiltration, necrosis, and fibrosis. the word is a local name in gold coast, africa, meaning displaced child. although first reported from africa, kwashiorkor is now known throughout the world, but mainly in the tropics and subtropics. it is considered to be related to marasmus. (from dorland, 27th ed)Kwashiorkor
malnutrition caused by severe protein deficiency. in contrast to marasmus, the total caloric intake is sufficient as the diet may be supported by other nutrients such as carbohydrates. signs may include peripheral edema and ascites.Marasmic Kwashiorkor|Marasmic kwashiorkor
evidence of marasmic kwashiorkor.
Patient EducationClinical
Malnutrition
Malnutrition means that your body isn't getting enough calories or the right balance of nutrients to stay healthy. This can happen if you don't get enough protein, carbohydrates, and fats, eat too much unhealthy food, or don't get the vitamins and minerals your body needs.
The full article covers:
- What is malnutrition?
- What are the types of malnutrition?
- What causes malnutrition?
- Who is at risk for developing malnutrition?
- What are the symptoms of malnutrition?
- How is malnutrition diagnosed?
- What are the treatments for malnutrition?
- Can malnutrition be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert E42 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About E42Overview
What is the ICD-10 code for marasmic kwashiorkor?
The ICD-10-CM code for marasmic kwashiorkor is E42. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is E42 (Marasmic kwashiorkor) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report marasmic kwashiorkor on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does E42 group to?
When marasmic kwashiorkor is the principal diagnosis on an inpatient stay, it groups to MS-DRG 640, 641, with relative weights from 0.7782 to 1.3356 depending on complications. Higher weights mean higher Medicare reimbursement.
Is E42 a CC or MCC?
CMS lists E42 as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 9 closely related codes in its exclusion list.
What is the ICD-9 equivalent of E42?
Under the General Equivalence Mappings, marasmic kwashiorkor converts to ICD-9-CM 260 (kwashiorkor). The mapping is approximate, so confirm the match fits the documentation.
Does E42 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. E42 mapped to HCC 21 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 21 (Protein-Calorie Malnutrition), ESRD (V21) category 21 (Protein-Calorie Malnutrition), and ESRD (V24) category 21 (Protein-Calorie Malnutrition).
