2026 ICD-10-CM Diagnosis Code E45Retarded development following protein-calorie malnutrition
ICD-10-CM Codes›E00–E89›E40-E46›E45
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Chronic Condition
E45 is a billable ICD-10-CM diagnosis code for retarded development following protein-calorie malnutrition. 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 complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 9 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Malnutrition.
E45 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
E45 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.
- Arrested development following protein-calorie malnutrition
- Developmental academic disorder due to nutritional stunting
- Dystrophy due to malnutrition
- Nutritional muscular degeneration
- Nutritional stunting
- Nutritional stunting in adolescence
- Nutritional stunting in childhood
- Nutritional stunting in infancy
- Physical retardation due to protein-calorie malnutrition
- Sequelae of nutritional disorders
- Sequelae of protein-energy malnutrition
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Nutritional short stature
- Nutritional stunting
- Physical retardation due to malnutrition
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.
Dwarfism See Also: Short, stature; E34.328
nutritional E45
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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 E45 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About E45Overview
What is the ICD-10 code for retarded development following protein-calorie malnutrition?
The ICD-10-CM code for retarded development following protein-calorie malnutrition is E45. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is E45 (Retarded development following protein-calorie malnutrition) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report retarded development following protein-calorie malnutrition on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does E45 group to?
When retarded development following protein-calorie malnutrition 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 E45 a CC or MCC?
CMS lists E45 as a CC (complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within 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 E45?
Under the General Equivalence Mappings, retarded development following protein-calorie malnutrition converts to ICD-9-CM 263.2 (arrest devel d/t malnutr). The mapping is approximate, so confirm the match fits the documentation.
Does E45 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. E45 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).
