PES statement
A PES statement is how a registered dietitian writes a nutrition diagnosis, step 2 of the Nutrition Care Process. It has three parts (Academy: Nutrition Diagnosis):
- P, Problem: a standardized nutrition diagnosis term.
- E, Etiology: the root cause, joined by "related to".
- S, Signs and symptoms: the assessment evidence, joined by "as evidenced by".
Nutrition diagnoses fall mainly into intake, clinical and behavioral-environmental domains in the Academy's terminology (eNCPT).
What a PES statement is not: it is not a medical diagnosis, and it does not go on the claim. ICD-10-CM guidelines let a dietitian's documentation support a BMI code, but the associated medical diagnosis must be documented by the patient's provider (ICD-10-CM Guidelines FY 2026, I.B.14).
Why it still matters for billing: a clear PES links the referral diagnosis to the intervention you delivered, which is exactly what a reviewer looks for when a payer requests records.