AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor

Anorexia Nervosa and Severe Malnutrition

Coding Clinic Fourth Quarter 1989 advised the sequencing of code 307.1, Anorexia nervosa, as principal diagnosis for anorexia with severe malnutrition since anorexia implies malnutrition. However, at my facility, we see patients with malnutrition so severe they require medical intervention for stabilization of body function. The monitoring and treatment for these patients may extend for months. We do not have a psychiatric ward and we aren’t associated with a psychiatric facility so no formalized psychiatric care is rendered beyond a psychiatric consultation. Since the primary reason for the admission is malnutrition, is it appropriate to sequence code 263.9, Unspecified protein-calorie malnutrition, as principal diagnosis? ...

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