Furthermore, clinicians relying on the International Classification of Diseases Volume 9 (ICD-9), which was the standard medical coding manual before 2009, were slow to adopt the new screening tools and most often diagnosed malnutrition with code 262 – Other Severe Protein-Calorie Malnutrition, or code 260 – Kwashiorkor (Table 1) utilizing low serum albumin as a primary diagnostic criterion. Here, ALB is linked to nutritional deficiency disease.