2026 ICD-10-CM Diagnosis Code E46

Unspecified protein-calorie malnutrition

ICD-10-CM Code:
E46
ICD-10 Code for:
Unspecified protein-calorie malnutrition
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

E46 is a billable diagnosis code used to specify a medical diagnosis of unspecified protein-calorie malnutrition. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026.

Unspecified diagnosis codes like E46 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Code Classification

  • Endocrine, nutritional and metabolic diseases
    E00–E89
    • Malnutrition
      E40-E46
      • Unspecified protein-calorie malnutrition
        E46

Approximate Synonyms

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

  • Acute disease or injury-related malnutrition
  • Acute malnutrition in adolescence
  • Acute malnutrition in childhood
  • Acute malnutrition in infancy
  • Cataract due to undernutrition
  • Cataract in systemic disorders
  • 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 due to malnutrition related diabetes mellitus
  • Disorder due to malnutrition related diabetes mellitus
  • Disorder due to malnutrition related diabetes mellitus
  • Disorder due to malnutrition related diabetes mellitus
  • Disorder due to malnutrition related diabetes mellitus
  • Disorder due to malnutrition related diabetes mellitus
  • Disorder of eye due to malnutrition related diabetes mellitus
  • Disorder of nervous system 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
  • Generalized redundant skin due to malnutrition
  • Gingival disease due to malnutrition
  • Hair changes due to malnutrition
  • Hair changes due to malnutrition
  • Hypertrichosis in malnutrition
  • Hypoalbuminemia
  • Hypoalbuminemia due to protein calorie malnutrition
  • Hypoproteinemia
  • Inadequate intake of energy
  • Inadequate intake of protein and/or protein derivative
  • Ketoacidosis due to secondary diabetes mellitus
  • Malnutrition
  • Malnutrition
  • Malnutrition due to child maltreatment
  • Malnutrition related diabetes mellitus
  • Malnutrition related diabetes mellitus
  • Malnutrition related diabetes mellitus
  • Malnutrition-dehydration cataract
  • Malnutrition-related diabetes mellitus - fibrocalculous
  • Malnutrition-related diabetes mellitus with ketoacidosis
  • Nutritional hair color change
  • Nutritional maltreatment of child
  • Nutritional myopathy
  • Nutritionally compromised
  • Peripheral circulatory disorder due to malnutrition-related diabetes mellitus
  • Peripheral vascular disease due to secondary diabetes mellitus
  • Peripheral vascular disorder due to diabetes mellitus
  • Pre-existing diabetes mellitus in pregnancy
  • Pre-existing malnutrition-related diabetes mellitus
  • Pre-existing malnutrition-related diabetes mellitus
  • Pre-existing malnutrition-related diabetes mellitus in pregnancy
  • Protein deficiency disease
  • Protein deficiency myopathy
  • Protein-deficient diabetes mellitus
  • Redundant skin
  • Skin changes due to malnutrition
  • Skin changes due to malnutrition
  • Skin changes due to malnutrition
  • Skin changes due to malnutrition
  • Starvation-related malnutrition
  • Undernutrition

Clinical Classification

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

Malnutrition

CCSR Code: END008

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Hypoalbuminemia

    a condition in which albumin level in blood (serum albumin) is below the normal range. hypoalbuminemia may be due to decreased hepatic albumin synthesis, increased albumin catabolism, altered albumin distribution, or albumin loss through the urine (albuminuria).
  • Child Nutrition Disorders

    disorders caused by nutritional imbalance, either overnutrition or undernutrition, occurring in children ages 2 to 12 years.
  • Fetal Nutrition Disorders

    disorders caused by nutritional imbalance, either overnutrition or undernutrition, in the fetus in utero.
  • Infant Nutrition Disorders

    disorders caused by nutritional imbalance, either overnutrition or undernutrition, occurring in infants ages 1 month to 24 months.
  • Malnutrition

    an imbalanced nutritional status resulting from insufficient intake of nutrients to meet normal physiological requirement.
  • 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.
  • Severe Acute Malnutrition

    acute form of malnutrition which usually affects children, characterized by a very low weight for height (below -3z scores of the median world health organization standards), visible severe wasting, or occurrence of nutritional edema. it can be a direct or indirect cause of fatality in children suffering from diarrhea and pneumonia. do not confuse with starvation, a condition in which the body is not getting enough food, usually for extended periods of time.
  • Diabetic Ketoacidosis

    a life-threatening complication of diabetes mellitus, primarily of type 1 diabetes mellitus with severe insulin deficiency and extreme hyperglycemia. it is characterized by ketosis; dehydration; and depressed consciousness leading to coma.
  • Hypoproteinemia

    a condition in which total serum protein level is below the normal range. hypoproteinemia can be caused by protein malabsorption in the gastrointestinal tract, edema, or proteinuria.
  • Protein-Losing Enteropathies

    pathological conditions in the intestines that are characterized by the gastrointestinal loss of serum proteins, including serum albumin; immunoglobulins; and at times lymphocytes. severe condition can result in hypogammaglobulinemia or lymphopenia. protein-losing enteropathies are associated with a number of diseases including intestinal lymphangiectasis; whipple's disease; and neoplasms of the small intestine.
  • Fetus

    the unborn young of a viviparous mammal, in the postembryonic period, after the major structures have been outlined. in humans, the unborn young from the end of the eighth week after conception until birth, as distinguished from the earlier embryo, mammalian.
  • Grade 1 Hypoalbuminemia, CTCAE|Grade 1 Hypoalbuminemia

  • Grade 2 Hypoalbuminemia, CTCAE|Grade 2 Hypoalbuminemia

    <3 - 2 g/dl; <30 - 20 g/l
  • APTX wt Allele|AOA|AOA1|AXA1|Aprataxin wt Allele|Ataxia 1, Early Onset With Hypoalbuminemia Gene|EAOH|EOAHA|FHA-HIT

    human aptx wild-type allele is located in the vicinity of 9p21.1 and is approximately 139 kb in length. this allele, which encodes aprataxin protein, is involved in dna repair. mutation of the gene is associated with ataxia-ocular apraxia type 1.
  • Ataxia-Oculomotor Apraxia Type 1|AOA1|Ataxia, Early-Onset, with Oculomotor Apraxia and Hypoalbuminemia|EAOH

    an autosomal recessive cerebellar ataxia caused by mutation(s) in the aptx gene, encoding aprataxin. it is characterized by peripheral axonal neuropathy, oculomotor apraxia, and hypoalbuminemia.
  • Grade 1 Hypoalbuminemia, CTCAE|Grade 1 Hypoalbuminemia

  • Grade 2 Hypoalbuminemia, CTCAE|Grade 2 Hypoalbuminemia

    <3-2 g/dl; <30-20 g/l
  • Grade 3 Hypoalbuminemia, CTCAE|Grade 3 Hypoalbuminemia

    <2 g/dl; <20 g/l
  • Grade 4 Hypoalbuminemia, CTCAE|Grade 4 Hypoalbuminemia

    life-threatening consequences; urgent intervention indicated
  • Grade 5 Hypoalbuminemia, CTCAE|Grade 5 Hypoalbuminemia

    death
  • Hypoalbuminemia

    concentration of serum albumin below normal limits for the age related normal range.
  • Hypoalbuminemia, CTCAE|Hypoalbuminemia|Hypoalbuminemia

    a disorder characterized by laboratory test results that indicate a low concentration of albumin in the blood.
  • Hypoproteinemia

    a laboratory test result indicating abnormally low levels of total protein in the serum.

Index to Diseases and Injuries References

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

Index of External Cause of Injuries

References found for this diagnosis code in the External Cause of Injuries Index:

    • Calorie deficiency or malnutrition
    • Cataract(cortical) (immature) (incipient)
      • in (due to)
        • malnutrition-dehydration
    • Cataract(cortical) (immature) (incipient)
      • malnutrition-dehydration
    • Deficiency, deficient
      • protein
    • Malnutrition
    • Malnutrition
      • protein
    • Malnutrition
      • protein
        • calorie
    • Malnutrition
      • protein
        • energy

Convert E46 to ICD-9-CM

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

Protein-cal malnutr NEC

ICD-9-CM: 263.8

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Protein-cal malnutr NOS

ICD-9-CM: 263.9

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Patient Education


Malnutrition

What is 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.

Malnutrition can affect people of all ages, but children, older adults, and people with chronic (long-term) health problems have a higher risk.

What are the types of malnutrition?

Most people think of undernutrition with malnutrition. But malnutrition can refer to undernutrition, overnutrition, or an imbalance of nutrients.

Types of malnutrition include:

  • Protein-energy undernutrition, also called macronutrient undernutrition, happens when your body doesn't get enough protein or calories from food. Two serious forms of this are kwashiorkor and marasmus.
  • An imbalanced nutritional status occurs when you are not getting the right mix of nutrients. You may get enough calories, but not enough vitamins or minerals.
  • Vitamin deficiency diseases happen when your body doesn't get enough of certain vitamins. Without the right vitamins, your body cannot stay healthy and may develop specific diseases. For example, scurvy can develop from too little vitamin C, rickets from too little vitamin D, and anemia from too little iron or vitamin B12.
  • Failure to thrive occurs when children don't gain weight or grow as expected. This may be due to not getting enough food, trouble absorbing nutrients, or other health problems.
  • Overnutrition can occur when your body gets too many calories or nutrients. This may lead to obesity or other health issues.

What causes malnutrition?

Malnutrition may occur for many reasons, including:

  • An unbalanced diet that lacks variety or specific nutrients.
  • Some medical issues, which could include malabsorption syndromes, dementia, eating disorders, depression, alcohol use disorder (AUD), or cancer.
  • Problems with swallowing, digestion, or dental issues.
  • Certain medicines that affect how food tastes and smells.
  • Not being able to get food or cook due to things such as chronic illness, mobility issues, or low income.

Who is at risk for developing malnutrition?

Malnutrition can affect anyone, but some people have a higher risk than others. This includes people who:

  • Don't have enough knowledge about nutrition
  • Don't have access to a variety of food
  • Are older adults or children
  • Have a low income
  • Have a chronic (long-term) illness

What are the symptoms of malnutrition?

The symptoms of malnutrition can vary. You may have no symptoms, but if you do, they may include:

  • Fatigue and weakness
  • Dizziness
  • Losing weight without trying
  • Low body weight
  • Slow growth or development in children
  • Frequent infections or slow healing
  • Dry skin or brittle hair and nails
  • Swelling in the legs, feet, or belly

How is malnutrition diagnosed?

To check for malnutrition, your provider may:

  • Do a nutritional screening, which may include questions about weight loss, changes in your appetite, and your ability to eat.
  • Do a physical exam and order blood tests to check for signs that you don't have enough nutrients.
  • Refer you to other providers that specialize in nutrition, such as a dietician.

What are the treatments for malnutrition?

Treatment for malnutrition may include improving your diet, replacing missing nutrients, and treating the underlying cause.

Can malnutrition be prevented?

To help prevent malnutrition, eat a healthy diet with many different foods. Talk with your provider if you are worried about your diet, weight loss, or your child's growth.


[Learn More in MedlinePlus]

Code History

  • FY 2026 - No Change, effective from 10/1/2025 through 9/30/2026
  • FY 2025 - No Change, effective from 10/1/2024 through 9/30/2025
  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.