Patient presents with Starvation Ketosis, secondary to prolonged caloric restriction.  The patient reports significantly decreased food intake for [duration], attributed to [reason for caloric restriction - e.g., financial hardship, eating disorder, restrictive diet].  Clinical findings include [Symptoms - e.g., weight loss, fatigue, weakness, nausea, lightheadedness, fruity breath odor].  Physical examination reveals [objective findings - e.g., dry mucous membranes, decreased skin turgor, hypotension, bradycardia].  Laboratory results demonstrate elevated serum ketones, [ketone level], and low blood glucose, [blood glucose level].  Differential diagnosis considered includes diabetic ketoacidosis, alcoholic ketoacidosis, and other metabolic disorders.  Diabetic ketoacidosis was ruled out based on [reason for exclusion - e.g., normal blood glucose, negative urine ketones].  Alcoholic ketoacidosis was ruled out based on [reason for exclusion - e.g., patient denies alcohol use].  Diagnosis of Starvation Ketosis is supported by the patient's history of restricted caloric intake, clinical presentation, and laboratory findings.  Treatment plan includes careful refeeding with [details of refeeding plan - e.g., gradual introduction of carbohydrates, electrolyte monitoring, intravenous fluids].  Patient education provided on the importance of adequate nutrition and the risks of prolonged fasting.  Follow-up scheduled in [ timeframe - e.g., 24-48 hours] to monitor electrolyte levels and clinical status.  ICD-10 code E43 is assigned for unspecified protein-calorie malnutrition.  This documentation supports medical necessity for services rendered.