E46: Unspecified protein-calorie malnutrition
E46, unspecified protein-calorie malnutrition, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 4 HCPCS Level II codes, including J3420 (Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg), J3425 (Injection, hydroxocobalamin, intramuscular, 10 mcg), G0127 (Trimming of dystrophic nails, any number). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with E46 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | Special coverage instructions apply | — | 1 |
| J3425 | Injection, hydroxocobalamin, intramuscular, 10 mcg | Special coverage instructions apply | — | 1 |
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 4 |
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 1 |
Medicare policy articles listing E46
- A57755: Billing and Coding: Vitamin B12 Injections (First Coast Service Options, Inc. (MAC - Part B); 2 Level II codes). LCD with the same title: L33967
- A57193: Billing and Coding: Routine Foot Care and Debridement of Nails (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A56389: Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34434
- A56232: Billing and Coding: Foot Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes)
- A57188: Billing and Coding: Routine Foot Care (First Coast Service Options, Inc. (MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56680: Billing and Coding: Routine Foot Care (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Frequently asked questions
Does Medicare cover E46 (Unspecified protein-calorie malnutrition)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list E46 as a covered diagnosis for 4 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 E46?
The Level II codes from the policies most specific to this diagnosis are J3420 (Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg, 1 article); J3425 (Injection, hydroxocobalamin, intramuscular, 10 mcg, 1 article); G0127 (Trimming of dystrophic nails, any number, 4 articles); J0585 (Injection, onabotulinumtoxina, 1 unit, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list E46?
A57755 (Billing and Coding: Vitamin B12 Injections); A57193 (Billing and Coding: Routine Foot Care and Debridement of Nails); A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization), and 3 more articles.
What is ICD-10-CM code E46?
E46 is the ICD-10-CM code for unspecified protein-calorie malnutrition, in category E46 (Unspecified protein-calorie malnutrition), chapter 4: Endocrine, nutritional and metabolic diseases.
Next steps
- Run a reimbursement report for a device billed under J3420
- Watch J3420 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3420
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 4: Endocrine, nutritional and metabolic diseases · All diagnoses · HCPCS lookup