Niacin deficiency [pellagra]

This code identifies a nutritional disorder resulting from inadequate intake or absorption of niacin (vitamin B3). Pellagra manifests with characteristic symptoms affecting the skin (dermatitis), gastrointestinal tract (diarrhea), and nervous system (dementia). It is a systemic deficiency impacting multiple organ systems.

Assign this code when documentation clearly indicates a diagnosis of niacin deficiency or pellagra. This typically occurs in cases of chronic malnutrition, alcoholism, or malabsorption syndromes. Supporting documentation includes clinical signs and symptoms consistent with pellagra, dietary history, and sometimes laboratory findings confirming low niacin levels.

• Do not code with E64.8 (sequelae of niacin deficiency) as per Excludes1 note; these conditions are mutually exclusive.
• Ensure documentation specifies active niacin deficiency, not residual effects from a past deficiency.
• Consider additional codes for associated conditions such as alcoholism (F10.-) or malabsorption (K90.-) if present and documented.