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R64 ICD-10-CM Code: Cachexia

Compare with another code for R64Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Official instructions
3 Excludes1
Risk adjustment
CMS-HCC V22 category 21

What these terms mean →

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Excludes1Not reported with this code unless documented as unrelated
  • abnormal weight loss (R63.4)
  • cachexia due to underlying condition (E88.A)
  • nutritional marasmus (E41)

Where it sits Source: CMS/NCHS

Under:Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere ClassifiedR50-R69 General symptoms and signs

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 947 — SIGNS AND SYMPTOMS WITH MCC (MDC 23)
  • MS-DRG 948 — SIGNS AND SYMPTOMS WITHOUT MCC (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R64 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Coder workflow for R64

MedCoder structured workflow — derived from this code’s own official record

Before you code R64

  1. Check whether an established diagnosis that explains this sign or symptom is documented. If one is, review whether the documented diagnosis changes the coding pathway: a symptom that is integral to a confirmed diagnosis is not reported separately, while one not routinely associated with it may be. Signs and symptoms are reported when no definitive diagnosis is established (Guidelines I.B.4, I.B.5, I.B.6, I.C.18.b).

    Guide: Symptom code vs confirmed diagnosis →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with R64. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Is an established diagnosis that explains this sign or symptom documented?
    Yes → Review whether the documented diagnosis changes the coding pathway: a symptom integral to it is not reported separately.
    No → Continue — the sign or symptom code stands when no definitive diagnosis is established.
  2. Does the documentation support a condition named in R64’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewR63.4, E88.A, E41

Consider R64. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting R64(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R64: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareR63.4, E88.A, E41

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The sign or symptom is documented, and the same record establishes a diagnosis that routinely includes it.

Coding question: Is R64 reported in addition to the diagnosis?

Path: Review the documented diagnosis and whether the classification treats this finding as integral to it.

Reason: Signs and symptoms integral to a confirmed diagnosis are not coded separately; those not routinely associated with it may be reported when present (Guidelines I.B.5, I.B.6, I.C.18.b).

Documentation: Both the condition R64 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewR63.4, E88.A, E41

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse R64 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of R64 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • R63.4— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of abnormal weight loss moves the case to R63.4; the two are not reported together unless documented as unrelated.

    Full comparison: R64 vs R63.4 →

  • E88.A— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of cachexia due to underlying condition moves the case to E88.A; the two are not reported together unless documented as unrelated.

    Full comparison: R64 vs E88.A →

  • E41— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nutritional marasmus moves the case to E41; the two are not reported together unless documented as unrelated.

    Full comparison: R64 vs E41 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Cachexia is a billable ICD-10-CM diagnosis code (R64).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name R64 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: E88.A — Wasting disease (syndrome) due to underlying condition.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 40 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 947 (MDC 23), DRG 948 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SYM016 — Other general signs and symptoms (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

R45.84 — Anhedonia, R46.0 — Very low level of personal hygiene, R46.1 — Bizarre personal appearance, R46.2 — Strange and inexplicable behavior, R46.3 — Overactivity, R46.4 — Slowness and poor responsiveness, R46.5 — Suspiciousness and marked evasiveness, R46.6 — Undue concern and preoccupation with stressful events, R46.7 — Verbosity and circumstantial detail obscuring reason for contact, R52 — Pain, unspecified, R68.0 — Hypothermia, not associated with low environmental temperature, R68.11 — Excessive crying of infant (baby), R68.12 — Fussy infant (baby), R68.13 — Apparent life threatening event in infant (ALTE), R68.19 — Other nonspecific symptoms peculiar to infancy, R68.81 — Early satiety, R68.82 — Decreased libido, R68.83 — Chills (without fever), R68.89 — Other general symptoms and signs, R69 — Illness, unspecified, +19 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other general signs and symptoms).

R63.2 — Polyphagia, R63.3 — Feeding difficulties, R63.30 — Feeding difficulties, unspecified, R63.31 — Pediatric feeding disorder, acute, R63.32 — Pediatric feeding disorder, chronic, R63.39 — Other feeding difficulties, R63.4 — Abnormal weight loss, R63.5 — Abnormal weight gain, R63.6 — Underweight, R63.8 — Other symptoms and signs concerning food and fluid intake, R65.10 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction, R65.11 — Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction, R68.0 — Hypothermia, not associated with low environmental temperature, R68.11 — Excessive crying of infant (baby), R68.12 — Fussy infant (baby), R68.13 — Apparent life threatening event in infant (ALTE), R68.19 — Other nonspecific symptoms peculiar to infancy, R68.2 — Dry mouth, unspecified, R68.3 — Clubbing of fingers, R68.81 — Early satiety, +38 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Inanition”, “Cachexia”, “Emaciation”; these codes share that main term but sit in a different category of the Tabular List.

D73.0 — Hyposplenism (splenica), E03.4 — Atrophy of thyroid (acquired) (strumipriva), E23.0 — Hypopituitarism (Simmonds'), E43 — Unspecified severe protein-calorie malnutrition (due to malnutrition), E86.0 — Dehydration (dehydration), E88.A — Wasting disease (syndrome) due to underlying condition (due to, malnutrition), F48.8 — Other specified nonpsychotic mental disorders (nervous), N28.9 — Disorder of kidney and ureter, unspecified (renal), R50.9 — Fever, unspecified (fever), R54 — Age-related physical debility (senile), T73.0 — Starvation (due to, deprivation of food)

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Blood Glucose Test, HIV Screening Test, Iron Panel

Contextual Map

Every relationship of R64 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run R64 with these 3 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

Clinical classification (CCSR)

MS-DRG Grouper

  • CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
  • DRG 947 — SIGNS AND SYMPTOMS WITH MCC[MS-DRG]: “SIGNS AND SYMPTOMS WITH MCC (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
  • DRG 948 — SIGNS AND SYMPTOMS WITHOUT MCC[MS-DRG]: “SIGNS AND SYMPTOMS WITHOUT MCC (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

MDC crossing

  • MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,258 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Cachexia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Cachexia, cancerous[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Cachexia, malignant[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Cachexia, pulmonary[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Emaciation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Inanition[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (6)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "R64 — Cachexia." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/r64-cachexia

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cachexia

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.