2027 ICD-10-CM Diagnosis Code R64Cachexia
ICD-10-CM Codes›R00–R99›R50-R69›R64
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Chronic Condition
R64 is a billable ICD-10-CM diagnosis code for cachexia. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 947 through 948. 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 40 closely related codes. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other general signs and symptoms.
R64 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
R64 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 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.
- Abnormal weight loss
- Abnormal weight loss associated with AIDS
- AIDS wasting syndrome
- Cachexia
- Cachexia associated with AIDS
- Café au lait spots
- Cardiac cachexia
- Diffuse dermatitis
- Distribution of body fat loss - finding
- Emaciated
- Facial dysmorphism, anorexia, cachexia, eye and skin anomalies syndrome
- Inanition
- Malignant cachexia
- Muscle cachexia
- Severe dermatitis, multiple allergies, metabolic wasting syndrome
- Severe systemic illness tissue wasting
- Weight decreased
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to R64: its own notes plus those printed at Chapter 18. 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.
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.
Notes
General instructions on how these codes are used.
- This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
- Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
- The conditions and signs or symptoms included in categories R00-R94 consist of:
- (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
- (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
- (c) provisional diagnosis in a patient who failed to return for further investigation or care;
- (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
- (e) cases in which a more precise diagnosis was not available for any other reason;
- (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name R64, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Cachexia
general ill health, malnutrition, and weight loss, usually associated with chronic disease.
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 R64 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About R64Overview
What is the ICD-10 code for cachexia?
The ICD-10-CM code for cachexia is R64. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is R64 (Cachexia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report cachexia on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does R64 group to?
When cachexia is the principal diagnosis on an inpatient stay, it groups to MS-DRG 948, 947, with relative weights from 0.7833 to 1.2608 depending on complications. Higher weights mean higher Medicare reimbursement.
Is R64 a CC or MCC?
CMS lists R64 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 40 closely related codes in its exclusion list.
Can R64 be a principal diagnosis?
Use it with care. This is a symptom code, so once a definitive diagnosis explaining the cachexia is established, that condition takes the principal position instead.
Does R64 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. R64 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).
