Global Malnutrition Composite Score

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Are you familiar with the Global Malnutrition Composite Score electronic clinical quality measures (eCQM)? Hospitals will begin reporting data on this measure CY 2024 under the Hospital Inpatient Quality Reporting Program for traditional Medicare beneficiaries.

This measure was developed because “. . . findings suggest that hospital-based malnutrition is significantly under-identified and under-diagnosed, and that other nutrition care practice gaps exist.” However, many payors challenge the validity of a malnutrition diagnosis when reported on a hospital claim. Implementation of this measure may create confusion among providers, but it may also help create coordination among nursing, dietary/nutritional services, providers, CDI and coding to capture and support the diagnosis of malnutrition both within the health record and in claims data more accurately.

This measure is NOT based on claims data. eCQMs are measures specified in a standard electronic format that use data electronically extracted from the electronic health record or health information technology systems. This measure has four components:

  1. Screen for malnutrition risk by registered nurse, registered dietician or registered dietitian nutritionist.
  2. Conduct nutrition assessment by registered dietician or registered dietitian nutritionist.
  3. Document malnutrition diagnosis by physician or qualified healthcare professional.
  4. Document nutrition care plan by registered dietician or registered dietitian nutritionist.

For this measure, the diagnosis of malnutrition can be identified by SNOMED code or ICD-10-CM code. It would be beneficial for CDI and coding professionals to know which code set will be sent for this measure to ensure consistency since claims billing uses ICD-10-CM codes.

The associated ICD-10-CM codes are:

  • E43, Unspecified severe protein-calorie malnutrition
  • E44.0, Moderate protein-calorie malnutrition
  • E45, Retarded development following protein-calorie malnutrition
  • E46, Unspecified protein-calorie malnutrition
  • T73.0XXA, Starvation, initial encounter
  • T73.0XXD, Starvation, subsequent encounter
  • T73.0XXS, Starvation, sequela


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