Cachexia (R64) is also known as ‘wasting’ or ‘wasting syndrome’. It is a general state of weakness involving marked weight and muscle loss. Emaciated is another term that may be found in the documentation that also maps to code R64.

These diagnoses are often missed since they are commonly only seen in the Physical Exam or Review of Systems portion of a record. There are often ‘knee-jerk’ reactions that can lead a coder to investigate further if a patient may have these diagnoses. 

What to look for

Cachexia is commonly seen in patients who have AIDS, cancer, or other advanced heart or lung disease. You will often see a lack of appetite, fatigue, low BMI, and malnutrition. Look for nutritional consults and a PEG tube in the documentation to trigger the search for cachexia in the documentation. 

Why is this so important? 

Cachexia is a diagnosis that can affect reimbursement for both Inpatient and Risk Adjustment. Don’t miss it!