2019 ICD-10-CM Diagnosis Code R65.11

Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction

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Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • code to identify specific acute organ dysfunction, such as:
  • acute kidney failure (
    ICD-10-CM Diagnosis Code N17
    • N17 Acute kidney failure
      • N17.0 Acute kidney failure with tubular necrosis
      • N17.1 Acute kidney failure with acute cortical necr...
      • N17.2 Acute kidney failure with medullary necrosis
      • N17.8 Other acute kidney failure
      • N17.9 Acute kidney failure, unspecified
  • acute respiratory failure (
    ICD-10-CM Diagnosis Code J96.0

    Acute respiratory failure

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
  • critical illness myopathy (
    ICD-10-CM Diagnosis Code G72.81

    Critical illness myopathy

      2016 2017 2018 2019 Billable/Specific Code
    Applicable To
    • Acute necrotizing myopathy
    • Acute quadriplegic myopathy
    • Intensive care (ICU) myopathy
    • Myopathy of critical illness
  • critical illness polyneuropathy (
    ICD-10-CM Diagnosis Code G62.81

    Critical illness polyneuropathy

      2016 2017 2018 2019 Billable/Specific Code
    Applicable To
    • Acute motor neuropathy
  • disseminated intravascular coagulopathy [DIC] (
    ICD-10-CM Diagnosis Code D65

    Disseminated intravascular coagulation [defibrination syndrome]

      2016 2017 2018 2019 Billable/Specific Code
    Applicable To
    • Afibrinogenemia, acquired
    • Consumption coagulopathy
    • Diffuse or disseminated intravascular coagulation [DIC]
    • Fibrinolytic hemorrhage, acquired
    • Fibrinolytic purpura
    • Purpura fulminans
    Type 1 Excludes
    • disseminated intravascular coagulation (complicating):
    • abortion or ectopic or molar pregnancy (O00-O07, O08.1)
    • in newborn (P60)
    • pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)
  • encephalopathy (metabolic) (septic) (
    ICD-10-CM Diagnosis Code G93.41

    Metabolic encephalopathy

      2016 2017 2018 2019 Billable/Specific Code
    Applicable To
    • Septic encephalopathy
  • hepatic failure (
    ICD-10-CM Diagnosis Code K72.0

    Acute and subacute hepatic failure

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Applicable To
    • Acute non-viral hepatitis NOS
The following code(s) above R65.11 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to R65.11:
  • R00-R99
    2019 ICD-10-CM Range R00-R99

    Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

    • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
    • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
    • The conditions and signs or symptoms included in categories R00-R94 consist of:
    • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
    • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
    • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
    • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
    • (e) cases in which a more precise diagnosis was not available for any other reason;
    • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
    Type 2 Excludes
    • abnormal findings on antenatal screening of mother (O28.-)
    • certain conditions originating in the perinatal period (P04-P96)
    • signs and symptoms classified in the body system chapters
    • signs and symptoms of breast (N63, N64.5)
    Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
  • R65.1
    ICD-10-CM Diagnosis Code R65.1

    Systemic inflammatory response syndrome (SIRS) of non-infectious origin

      2016 2017 2018 2019 Non-Billable/Non-Specific Code
    Code First
    • underlying condition, such as:
    • heatstroke (T67.0)
    • injury and trauma (S00-T88)
    Type 1 Excludes
    • sepsis- code to infection
    • severe sepsis (R65.2)
    Systemic inflammatory response syndrome (SIRS) of non-infectious origin
Approximate Synonyms ICD-10-CM R65.11 is grouped within Diagnostic Related Group(s) (MS-DRG v36.0):

Convert R65.11 to ICD-9-CM

Code History

Diagnosis Index entries containing back-references to R65.11:

ICD-10-CM Codes Adjacent To R65.11
R63.2 Polyphagia
R63.3 Feeding difficulties
R63.4 Abnormal weight loss
R63.5 Abnormal weight gain
R63.6 Underweight
R63.8 Other symptoms and signs concerning food and fluid intake
R64 Cachexia
R65 Symptoms and signs specifically associated with systemic inflammation and infection
R65.1 Systemic inflammatory response syndrome (SIRS) of non-infectious origin
R65.10 …… without acute organ dysfunction
R65.11 …… with acute organ dysfunction
R65.2 Severe sepsis
R65.20 …… without septic shock
R65.21 …… with septic shock
R68 Other general symptoms and signs
R68.0 Hypothermia, not associated with low environmental temperature
R68.1 Nonspecific symptoms peculiar to infancy
R68.11 Excessive crying of infant (baby)
R68.12 Fussy infant (baby)
R68.13 Apparent life threatening event in infant (ALTE)
R68.19 Other nonspecific symptoms peculiar to infancy

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