E41 vs E42
E41 (Nutritional marasmus) compared with E42 (Marasmic kwashiorkor), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. E41 carries an Excludes1 note covering E42: “marasmic kwashiorkor (E42)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| E41Nutritional marasmus | E42Marasmic kwashiorkor | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) |
| Definition | Nutritional marasmus is a billable ICD-10-CM diagnosis code (E41). | Marasmic kwashiorkor is a billable ICD-10-CM diagnosis code (E42). |
| Includes | Severe malnutrition with marasmus | Intermediate form severe protein-calorie malnutrition Severe protein-calorie malnutrition with signs of both kwashiorkor and marasmus |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources