Manual of Clinical Nutrition

Body Weight Evaluation

Manual of Clinical Nutrition Management II- 3 Copyright © 2013 Compass Group, Inc.

Nutrition Diagnosis Etiologies (Causes) Nutrition Assessment Indicators

Inadequate protein-

energy intake (NI-

5.3)

Inadequate intake of

protein and/or

energy compared to

established reference

standards or

recommendations

based on

physiological needs

of short or recent

duration

Same as malnutrition

Biochemical:

Normal albumin (in the setting of normal liver function

despite decreased protein-energy intake)

Anthropometric:

Inadequate maternal weight gain

Weight loss of 7.5% during past 3 months, > 5% in one

month, 1 to 2 % in one week in adults, any weight loss

or failure to gain weight in children.

Nutrition-focused physical finding:

Slow or delayed wound healing

Food/nutrition and client history:

Intake analysis less than estimated or measured energy

requirements

Restriction or omission of food groups such as dairy or

meat groups (protein) or bread or milk group (energy)

Nutrient malabsorption (eg, bariatric surgery)

a Two or more indicators must be present to determine a nutrition diagnosis of malnutrition (3).

Adapted from: International Dietetics & Nutrition Terminology (IDNT) Reference Manual. 4th ed. Chicago, Ill: Academy of Nutrition and

Dietetics; 2012.

Table II-5: ICD- 9 - CM Codes For Nutrition-Related Disorders

ICD- 9 - CM

Code Number

Diagnosisa Criteriab

260.0 Kwashiorkor Nutritional edema with dyspigmentation of skin and

hair

261.0 Nutritional marasmus Nutritional atrophy; severe, chronic calorie deficiency;

severe malnutrition

262.0 Other severe protein-energy

malnutrition

Nutritional edema without mention of

dyspigmentation of skin and hair

263.0 Protein-energy malnutrition

of moderate degree

Refer to Tables II: 1-3 for nutritional indicators of

malnutrition.

263.1 Protein-energy malnutrition

of mild degree

Refer to Tables II: 1-3 for nutritional indicators of

malnutrition.

263.8 Other protein-calorie

malnutrition

Criteria is not available. Refer to Tables II: 1-3 for

nutritional indicators of malnutrition.

263.9 Unspecified protein-calorie

malnutrition, calorie

malnutrition

A disorder caused by a lack of proper nutrition or an

inability to absorb nutrients from food

An imbalanced nutritional status caused by

insufficient intake of nutrients to meet normal

physiological requirements

579.3 Other and unspecified

postsurgical nonabsorption

Hypoglycemia or malnutrition following

gastrointestinal surgery

783.2 Abnormal loss of weight and

underweight

BMI <18.5 kg/m^2 (<23 kg/m^2 in older adults 65+

years)(5); also refer t Table II:1

783.21 and/or

V85.0

Loss of weight BMI <18.5 kg/m^2 ; also refer to Table II: 1

783.22 and/or

V85.0

Underweight BMI <18.5 kg/m^2

aMalnourished individuals may meet criteria for these billable ICD- 9 - CM codes.
b The 10th revision (ICD-10) of the codes is scheduled for implementation in 2013 and will change some of the definitions as shown in the
Table II-5. The Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) have
proposed new malnutrition codes to the National Center for Health and Vital Statistics for inclusion. At this time acute-phase hepatic