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ICD-10 Coding for Failure to Thrive(R62.51, R62.52, R62.7)

Complete ICD-10-CM coding and documentation guide for Failure to Thrive. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

FTTGrowth FailureWeight Faltering

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Related ICD-10 Code Ranges

Complete code families applicable to Failure to Thrive

R62.5-R62.7Primary Range

Lack of expected normal physiological development

This range includes codes specifically for failure to thrive across different age groups.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
R62.51Failure to thrive (child)Use for children under 5 years with documented growth failure without a specific underlying cause.
  • Weight below 5th percentile
  • Documented feeding issues
R62.52Failure to thrive (older child)Use for children aged 5-17 years with documented growth failure.
  • Growth chart showing decline in weight percentile
  • Documented caloric intake below recommended levels
R62.7Adult failure to thriveUse for adults with documented significant weight loss and functional decline.
  • BMI <18.5
  • Significant weight loss over a short period

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for failure to thrive

Essential facts and insights about Failure to Thrive

The ICD-10 code for failure to thrive in children under 5 years is R62.51, and for children aged 5-17 years, it is R62.52.

Primary ICD-10-CM Codes for failure to thrive

R62.51
Failure to thrive (child)
Billable Code

Decision Criteria

clinical Criteria

  • Weight below 5th percentile with feeding issues

Applicable To

  • Failure to thrive in children under 5 years

Excludes

Clinical Validation Requirements

  • Weight below 5th percentile
  • Documented feeding issues

Code-Specific Risks

  • Incorrect sequencing with underlying conditions

Coding Notes

  • Ensure growth charts and feeding history are documented.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Body mass index (BMI) pediatric, less than 5th percentile for age

Z68.51
Use to document BMI percentile in pediatric patients.

Body mass index (BMI) pediatric, 5th to less than 85th percentile for age

Z68.52
Use to document BMI percentile in older children.

Body mass index (BMI) 19 or less, adult

Z68.1
Use to document BMI in adults.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Unspecified severe protein-calorie malnutrition

E43
Use E43 when malnutrition is the primary cause of growth failure.

Gastro-esophageal reflux disease without esophagitis

K21.9
Use K21.9 when GERD is the primary cause of growth failure.

Moderate protein-calorie malnutrition

E44.0
Use E44.0 when moderate malnutrition is the primary cause.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Failure to Thrive to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R62.51.

Impact

Clinical: Inaccurate assessment of growth trends., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.

Mitigation Strategy

Ensure growth charts are updated at each visit., Include percentile data in clinical notes.

Impact

Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health records.

Mitigation Strategy

Use R62.51 or R62.52 based on the patient's age.

Impact

Reimbursement: Incorrect DRG assignment affecting payment., Compliance: Violates coding sequencing rules., Data Quality: Misrepresents clinical picture.

Mitigation Strategy

Code malnutrition (E43) before FTT (R62.51).

Impact

Failure to sequence underlying conditions before FTT.

Mitigation Strategy

Regular training on ICD-10 sequencing rules.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Failure to Thrive, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Failure to Thrive

Use these documentation templates to ensure complete and accurate documentation for Failure to Thrive. These templates include all required elements for proper coding and billing.

Pediatric Failure to Thrive

Specialty: Pediatrics

Required Elements

  • Growth chart percentiles
  • Feeding history
  • Developmental milestones

Example Documentation

Patient's weight has declined from the 25th to the 3rd percentile over 8 weeks despite adequate caloric intake.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Child not growing well.
Good Documentation Example
Weight trajectory declined from 25th to 3rd percentile over 8 weeks despite 110 kcal/kg/day intake; negative metabolic workup.
Explanation
The good example provides specific growth metrics and dietary intake, supporting the diagnosis.

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