2027 ICD-10-CM Diagnosis Code E64.0Sequelae of protein-calorie malnutrition

ICD-10-CM Codes›E00–E89›E50-E64›E64

ICD-10-CM E64.0
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

E64.0 is a billable ICD-10-CM diagnosis code for sequelae of protein-calorie malnutrition. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 640 through 641, 791, 793. 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. The code is exempt from POA reporting. Coders also document this condition as cachectic alopecia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Sequela of malnutrition and other nutritional deficiencies.

E64.0 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 2027.

Code Identity

ICD-10-CM Code
E64.0
Billable Status
Yes — Valid for Submission
Code Describes
Sequelae of protein-calorie malnutrition
Short Description
Sequelae of protein-calorie malnutrition
Same as the full description in the CMS dataset.
Parent Code
E64
Sequelae of malnutrition and other nutritional deficiencies

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE50-E64Other nutritional deficiencies
CategoryE64Sequelae of malnutrition and other nutritional deficiencies
This CodeE64.0Sequelae of protein-calorie malnutrition

Present on Admission (POA)Billing

E64.0 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Other nutritional deficiencies (E50-E64).

Medicare Risk Adjustment (HCC)Billing

E64.0 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.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 21
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 21 · ESRD (V21): HCC 21 · ESRD (V24): HCC 21
ESRD V21 weights: 0.055 dialysis, 0.252–0.593 functioning graft · ESRD V24 weights: 0.068 dialysis, 0.326–0.963 functioning graft
Part D (RxHCC)
Not mapped
E64.0 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 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.

  • Cachectic alopecia
  • Sequelae of nutritional disorders
  • Sequelae of protein-energy malnutrition

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to E64.0: its own notes plus those printed at E64, block E50-E64, and Chapter 4. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • transitory endocrine and metabolic disorders specific to newborn (P70-P74)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

On E64.0 itself
  • retarded development following protein-calorie malnutrition (E45)
From Block E50-E64 Other nutritional deficiencies applies to 50 codes

Code First

The underlying condition named in the note is sequenced before this code.

From E64 Sequelae of malnutrition and other nutritional deficiencies applies to 6 codes
  • condition resulting from (sequela) of malnutrition and other nutritional deficiencies

Notes

General instructions on how these codes are used.

From E64 Sequelae of malnutrition and other nutritional deficiencies applies to 6 codes
  • This category is to be used to indicate conditions in categories E43, E44, E46, E50-E63 as the cause of sequelae, which are themselves classified elsewhere. The 'sequelae' include conditions specified as such; they also include the late effects of diseases classifiable to the above categories if the disease itself is no longer present
From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • 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: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name E64.0, its category, or a range that includes it.

Applicable To 1

These notes mention E64.0.

  • P00.4 Newborn affected by maternal nutritional disorders
    Newborn affected by maternal disorders classifiable to E40-E64 names E40-E64, which includes this code

Excludes1 3

These codes carry an Excludes1 note naming E64.0: they are not reported together with it, unless the two conditions are unrelated.

  • Block E40-E46 Malnutrition
    sequelae of protein-calorie malnutrition (E64.0)
  • E61 Deficiency of other nutrient elements
    sequelae of malnutrition and other nutritional deficiencies (E64.-) names E64.-, which includes this code
  • Z72.4 Inappropriate diet and eating habits
    malnutrition and other nutritional deficiencies (E40-E64) names E40-E64, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming E64.0: its condition is not part of those codes, and both may be reported when the patient has both.

  • E63 Other nutritional deficiencies
    sequelae of malnutrition and other nutritional deficiencies (E64.-) names E64.-, which includes this code

Code First 1

These codes say to code first a condition named in the note, and E64.0 is one of the conditions named.

  • G63 Polyneuropathy in diseases classified elsewhere
    nutritional deficiency (E40-E64) names E40-E64, which includes this 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.

CCSR END017
Sequela of malnutrition and other nutritional deficiencies
Default principal diagnosis: inpatient Yes · outpatient Yes

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 E64.0 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
263.9 Protein-cal malnutr NOS
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About E64.0Overview

What is the ICD-10 code for sequelae of protein-calorie malnutrition?

The ICD-10-CM code for sequelae of protein-calorie malnutrition is E64.0 (sometimes written as E640). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is E64.0 (Sequelae of malnutrition and other nutritional deficiencies) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sequelae of protein-calorie malnutrition on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does E64.0 group to?

When sequelae of protein-calorie malnutrition is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 641, 640, with relative weights from 0.7864 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is E64.0 a CC or MCC?

CMS lists E64.0 as a CC (complication or comorbidity) for FY 2027. 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.

Is E64.0 exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for sequelae of protein-calorie malnutrition on inpatient claims. The code appears in the Other nutritional deficiencies (E50-E64) range of the CMS exempt list.

Does E64.0 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. E64.0 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).