ICD-10 Coding for Poor Weight Gain(R62.51, R63.5, E43)
Complete ICD-10-CM coding and documentation guide for Poor Weight Gain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Poor Weight Gain
R62.5Primary Range
Codes for Failure to Thrive
This range includes codes for failure to thrive, which is a primary concern in poor weight gain, especially in pediatric populations.
Codes for Abnormal Weight Gain
This range includes codes for abnormal weight gain, which can be related to poor weight gain when no specific cause is identified.
Codes for Severe Malnutrition
Severe malnutrition is often a consequence or associated condition with poor weight gain, requiring specific documentation and coding.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R62.51 | Failure to thrive (child) | Use for children under 5 years with documented failure to thrive. |
|
| R63.5 | Abnormal weight gain | Use when weight gain is present without a specific underlying condition. |
|
| E43 | Unspecified severe protein-calorie malnutrition | Use when severe malnutrition is documented with specific clinical findings. |
|
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 poor weight gain
Essential facts and insights about Poor Weight Gain
Primary ICD-10-CM Codes for poor weight gain
Decision Criteria
clinical Criteria
- Child under 5 with significant growth delay
Applicable To
- Failure to thrive in children under 5 years
Excludes
- Malnutrition (E40-E46)
Clinical Validation Requirements
- Growth parameters below the 3rd percentile
- Crossing two major growth percentiles downward
Code-Specific Risks
- Incorrect use without proper growth chart documentation
Coding Notes
- Ensure growth charts and nutritional assessments are documented.
R63.5 - Abnormal weight gain
Use when weight gain is present without a specific underlying condition.
Applicable To
- Unexplained weight gain
Excludes
- Weight gain due to pregnancy (O26.0-)
Clinical Validation Requirements
- Weight gain without identifiable cause
- Exclusion of other conditions like obesity
Coding Notes
Ensure no underlying conditions are documented.
E43 - Unspecified severe protein-calorie malnutrition
Use when severe malnutrition is documented with specific clinical findings.
Applicable To
- Severe malnutrition
Excludes
- Mild malnutrition (E44.1)
Clinical Validation Requirements
- BMI <18.5
- Significant weight loss >20%
Coding Notes
Document specific malnutrition metrics.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Noncompliance with medical treatment
Z91.19Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Poor Weight Gain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R62.51.
Impact
Clinical: May lead to misdiagnosis, Regulatory: Non-compliance with documentation standards, Financial: Potential for denied claims
Mitigation Strategy
Use specific growth metrics, Include detailed nutritional assessments
Impact
Reimbursement: May lead to incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Identify and code the underlying condition first.
Impact
Lack of detailed growth metrics can trigger audits.
Mitigation Strategy
Ensure all growth data is accurately documented and updated.
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 Poor Weight Gain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Poor Weight Gain
Use these documentation templates to ensure complete and accurate documentation for Poor Weight Gain. These templates include all required elements for proper coding and billing.
Pediatric failure to thrive
Specialty: PediatricsRequired Elements
- Growth parameters
- Nutritional intake
- Psychosocial factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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