ICD-10-CM Code E46

Unspecified protein-calorie malnutrition

Version 2021 Billable Code

Valid for Submission

E46 is a billable code used to specify a medical diagnosis of unspecified protein-calorie malnutrition. The code is valid for the fiscal year 2021 for the submission of HIPAA-covered transactions. The ICD-10-CM code E46 might also be used to specify conditions or terms like acute disease or injury-related malnutrition, acute malnutrition in adolescence, acute malnutrition in childhood, acute malnutrition in infancy, child neglect, chronic disease-related malnutrition, etc

Short Description:Unspecified protein-calorie malnutrition
Long Description:Unspecified protein-calorie malnutrition

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code E46:

Inclusion Terms

Inclusion Terms
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.
  • Malnutrition NOS
  • Protein-calorie imbalance NOS

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • nutritional deficiency NOS E63.9

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code E46 are found in the index:


The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Acute disease or injury-related malnutrition
  • Acute malnutrition in adolescence
  • Acute malnutrition in childhood
  • Acute malnutrition in infancy
  • Child neglect
  • Chronic disease-related malnutrition
  • Coma due to malnutrition-related diabetes mellitus
  • Deficiency of macronutrients
  • Diabetes mellitus associated with pancreatic disease
  • Diabetic ketoacidosis
  • Disorder of eye due to malnutrition related diabetes mellitus
  • Disorder of nervous system due to malnutrition related diabetes mellitus
  • Disorder of vision due to secondary diabetes mellitus
  • Fibrocalculous pancreatic diabetes
  • Gingival disease due to malnutrition
  • Hair changes due to malnutrition
  • Hypertrichosis in malnutrition
  • Hypoalbuminemia
  • Hypoalbuminemia due to protein calorie malnutrition
  • Hypoproteinemia
  • Inadequate dietary intake of protein
  • Ketoacidosis due to secondary diabetes mellitus
  • Malnutrition
  • Malnutrition
  • Malnutrition due to child maltreatment
  • Malnutrition related diabetes mellitus
  • Malnutrition-dehydration cataract
  • Malnutrition-related diabetes mellitus - fibrocalculous
  • Malnutrition-related diabetes mellitus with ketoacidosis
  • Malnutrition-related diabetes mellitus with peripheral circulatory complications
  • Malnutrition-related diabetes mellitus with renal complications
  • Malnutrition-related diabetes mellitus without complications
  • Multiple complications due to malnutrition related diabetes
  • Nutritional hair color change
  • Nutritional maltreatment of child
  • Nutritional myopathy
  • Nutritionally compromised
  • O/E - undernourished
  • Pre-existing malnutrition-related diabetes mellitus
  • Protein deficiency disease
  • Protein deficiency myopathy
  • Protein-deficient diabetes mellitus
  • Skin changes due to malnutrition
  • Starvation-related malnutrition
  • Undernutrition

Clinical Information

  • PROTEIN ENERGY MALNUTRITION-. the lack of sufficient energy or protein to meet the body's metabolic demands as a result of either an inadequate dietary intake of protein intake of poor quality dietary protein increased demands due to disease or increased nutrient losses.

Diagnostic Related Groups

The ICD-10 code E46 is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2020 through 09/30/2021.


Convert E46 to ICD-9

  • 263.8 - Protein-cal malnutr NEC (Approximate Flag)
  • 263.9 - Protein-cal malnutr NOS (Approximate Flag)

Code Classification

  • Endocrine, nutritional and metabolic diseases (E00–E90)
    • Malnutrition (E40-E46)
      • Unspecified protein-calorie malnutrition (E46)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021

Information for Patients


Food provides the energy and nutrients you need to be healthy. If you don't get enough nutrients -- including proteins, carbohydrates, fats, vitamins, and minerals - you may suffer from malnutrition.

Causes of malnutrition include:

  • Lack of specific nutrients in your diet. Even the lack of one vitamin can lead to malnutrition.
  • An unbalanced diet
  • Certain medical problems, such as malabsorption syndromes and cancers

Symptoms may include fatigue, dizziness, and weight loss. Or, you may have no symptoms. To diagnose the cause of the problem, your doctor may do blood tests and a nutritional assessment. Treatment may include replacing the missing nutrients and treating the underlying cause.

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