ICD-10 E45
Billable / Specific HCC v28: 21 CCRetarded development following protein-calorie malnutrition
About ICD-10-CM E45
ICD-10-CM code E45 represents Retarded development following protein-calorie malnutrition. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E45). The 2026 edition of ICD-10-CM E45 became effective on October 1, 2025.
Coding Tips for E45
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E45 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.
E45 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC 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 E45. Per CMS ICD-10-CM Tabular 2026.
- Nutritional short stature
- Nutritional stunting
- Physical retardation due to malnutrition
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, CC
codes Retarded development following protein-calorie malnutrition. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for E45
Local Coverage Determinations (LCDs) from CMS MACs that list E45 as a covered diagnosis.
Showing top 10 of 33 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E45.
1 Aetna
3 Medicare
Convert E45 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 |
|---|---|---|
| E45 | 2632 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To E45
Other codes in section E40-E46 (Malnutrition).
ICD-10 E45, Billing FAQ
Is ICD-10 code E45 billable? +
Yes, E45 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 E45? +
ICD-10 E45 includes: Nutritional short stature; Nutritional stunting; Physical retardation due to malnutrition.
Does E45 affect Medicare Advantage HCC risk adjustment? +
Yes. E45 maps to CMS-HCC v28 category 21. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is E45 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with E45? +
Procedures frequently paired with E45 include: J3420, J3425.
What ICD-9 codes does E45 map to? +
Per CMS GEMs, E45 maps to ICD-9 codes: 2632. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team