ICD-10 E41
Billable / Specific HCC v28: 21 MCCNutritional marasmus
About ICD-10-CM E41
ICD-10-CM code E41 represents Nutritional marasmus. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E41). The 2026 edition of ICD-10-CM E41 became effective on October 1, 2025.
Coding Tips for E41
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E41 is a CMS-HCC v28 risk-adjustment code (category 21). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
E41 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under E41. Per CMS ICD-10-CM Tabular 2026.
- Severe malnutrition with marasmus
Type 1 Excludes
Pure excludes, these codes can never be coded together with E41. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- marasmic kwashiorkor (E42)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, MCC
codes Nutritional marasmus. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for E41
Local Coverage Determinations (LCDs) from CMS MACs that list E41 as a covered diagnosis.
Showing top 10 of 176 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E41.
1 Aetna
1 Cigna
5 Medicare
1 Humana
Convert E41 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| E41 | 261 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E41
Other codes in section E40-E46 (Malnutrition).
ICD-10 E41, Billing FAQ
Is ICD-10 code E41 billable? +
Yes, E41 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to E41? +
ICD-10 E41 includes: Severe malnutrition with marasmus.
What codes are Type 1 Excludes for E41? +
Type 1 Excludes (never code together with E41): marasmic kwashiorkor (E42)
Does E41 affect Medicare Advantage HCC risk adjustment? +
Yes. E41 maps to CMS-HCC v28 category 21. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is E41 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with E41? +
Procedures frequently paired with E41 include: J3420, J3425.
What ICD-9 codes does E41 map to? +
Per CMS GEMs, E41 maps to ICD-9 codes: 261. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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