WHO Establishes First-Ever ICD Code for Undernutrition in Clinical Settings for Adults

The Academy of Nutrition and Dietetics (and the Academy) and the American Society of Nutrition (ASN) are pleased that the World Health Organization (WHO) has released notification that starting in 2027, ICD-11 (International Classification of Diseases version 11), for the first time, will include a code for undernutrition in clinical settings for adults.

This change has important implications for physicians, physician extenders and registered dietitian nutritionists (RDNs) who care for patients in a variety of clinical settings. The WHO has used the term "undernutrition" instead of "malnutrition" to specifically describe loss of mass (weight, body mass index or muscle mass) in the context of disease, inflammation or starvation. This undernutrition code does not exclude individuals living with overweight or obesity; however, the loss of weight or muscle in combination with the existence of clinical diagnoses that may be associated with inflammation or starvation must be present.

Population-specific, validated tools such as the Subjective Global Assessment (SGA), the Academy/American Society of Parenteral and Enteral Nutrition (ASPEN) Indicators (AAIM), the Mini Nutrition Assessment (MNA), and the Global Leadership in Malnutrition (GLIM) can be used to determine whether a patient has undernutrition. The tool criteria or variables that confirm the diagnosis for the ICD-11 code must follow these new WHO requirements. This code aligns with the electronic quality measure for malnutrition (malnutrition care score [MCS]). The quality measure data can be used to improve the quality of care in hospitalized patients.

This opportunity to standardize the diagnosis of undernutrition in adults with this new diagnostic coding algorithm will enhance health care practitioners' ability to recognize the prevalence of undernutrition, identify treatments that effectively resolve undernutrition and determine the impact of undernutrition on health outcomes. The implementation of a common and universal language to support the diagnosis of undernutrition will present tremendous opportunities for global cooperation to tackle this serious health challenge.