ICD-10-CM Codes
R00-R99
R50-R69
R65-
2023 ICD-10-CM Diagnosis Code R65.2

2023 ICD-10-CM Diagnosis Code R65.2

Severe sepsis

2016

2017

2018

2019

2020

2021

2022

2023

Non-Billable/Non-Specific Code

R65.2 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
The 2023 edition of ICD-10-CM R65.2 became effective on October 1, 2022.
This is the American ICD-10-CM version of R65.2 - other international versions of ICD-10 R65.2 may differ.

Applicable To

Infection with associated acute organ dysfunction
Sepsis with acute organ dysfunction
Sepsis with multiple organ dysfunction
Systemic inflammatory response syndrome due to infectious process with acute organ dysfunction

Use Additional

Use Additional Help

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
N17.-
)
acute respiratory failure (
ICD-10-CM Diagnosis Code J96.0
Acute respiratory failure
J96.0-
)
critical illness myopathy (
ICD-10-CM Diagnosis Code G72.81
Critical illness myopathy
Applicable To
- Acute necrotizing myopathy
- Acute quadriplegic myopathy
- Intensive care (ICU) myopathy
- Myopathy of critical illness
G72.81
)
critical illness polyneuropathy (
ICD-10-CM Diagnosis Code G62.81
Critical illness polyneuropathy
Applicable To
- Acute motor neuropathy
G62.81
)
disseminated intravascular coagulopathy [DIC] (
ICD-10-CM Diagnosis Code D65
Disseminated intravascular coagulation [defibrination syndrome]
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)
D65
)
encephalopathy (metabolic) (septic) (
ICD-10-CM Diagnosis Code G93.41
Metabolic encephalopathy
Applicable To
- Septic encephalopathy
G93.41
)
hepatic failure (
ICD-10-CM Diagnosis Code K72.0
Acute and subacute hepatic failure
Applicable To
- Acute non-viral hepatitis NOS
K72.0-
)

Code First

Code First Help

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, 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.

underlying infection, such as:
infection following a procedure (
ICD-10-CM Diagnosis Code T81.4
Infection following a procedure
Applicable To
- Wound abscess following a procedure
Type 2 Excludes
- bleb associated endophthalmitis (H59.4-)
- infection due to infusion, transfusion and therapeutic injection (T80.2-)
- infection due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)
- obstetric surgical wound infection (O86.0-)
- postprocedural fever NOS (R50.82)
- postprocedural retroperitoneal abscess (K68.11)
Use Additional
- code to identify infection
T81.4-
)
infections following infusion, transfusion and therapeutic injection (
ICD-10-CM Diagnosis Code T80.2
Infections following infusion, transfusion and therapeutic injection
Type 2 Excludes
- infections specified as due to prosthetic devices, implants and grafts (T82.6-T82.7, T83.5-T83.6, T84.5-T84.7, T85.7)
- postprocedural infections (T81.4-)
Use Additional
- code to identify the specific infection, such as:
- sepsis (A41.9)
T80.2-
)
puerperal sepsis (
ICD-10-CM Diagnosis Code O85
Puerperal sepsis
Applicable To
- Postpartum sepsis
- Puerperal peritonitis
- Puerperal pyemia
Type 1 Excludes
- fever of unknown origin following delivery (O86.4)
- genital tract infection following delivery (O86.1-)
- obstetric pyemic and septic embolism (O88.3-)
- puerperal septic thrombophlebitis (O86.81)
- urinary tract infection following delivery (O86.2-)
Type 2 Excludes
- sepsis during labor (O75.3)
Use Additional
- code (B95-B97), to identify infectious agent
O85
)
sepsis following complete or unspecified spontaneous abortion (
ICD-10-CM Diagnosis Code O03.87
Sepsis following complete or unspecified spontaneous abortion
Type 1 Excludes
- septic or septicopyemic embolism following complete or unspecified spontaneous abortion (O03.7)
Use Additional
- code to identify infectious agent (B95-B97)
O03.87
)
sepsis following ectopic and molar pregnancy (
ICD-10-CM Diagnosis Code O08.82
Sepsis following ectopic and molar pregnancy
Type 1 Excludes
- septic or septicopyemic embolism following ectopic and molar pregnancy (O08.2)
Use Additional
- code (B95-B97), to identify infectious agent
O08.82
)
sepsis following incomplete spontaneous abortion (
ICD-10-CM Diagnosis Code O03.37
Sepsis following incomplete spontaneous abortion
Type 1 Excludes
- septic or septicopyemic embolism following incomplete spontaneous abortion (O03.2)
Use Additional
- code to identify infectious agent (B95-B97)
O03.37
)
sepsis following (induced) termination of pregnancy (
ICD-10-CM Diagnosis Code O04.87
Sepsis following (induced) termination of pregnancy
Type 1 Excludes
- septic or septicopyemic embolism following (induced) termination of pregnancy (O04.7)
Use Additional
- code to identify infectious agent (B95-B97)
O04.87
)
sepsis NOS (
ICD-10-CM Diagnosis Code A41.9
Sepsis, unspecified organism
Applicable To
- Septicemia NOS
A41.9
)

The following code(s) above R65.2 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 R65.2:

R00-R99
2023 ICD-10-CM Range R00-R99
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Note
- 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

Clinical Information

Sepsis associated with organ dysfunction distant from the site of infection.

Code History

2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
2017 (effective 10/1/2016): No change
2018 (effective 10/1/2017): No change
2019 (effective 10/1/2018): No change
2020 (effective 10/1/2019): No change
2021 (effective 10/1/2020): No change
2022 (effective 10/1/2021): No change
2023 (effective 10/1/2022): No change

Code annotations containing back-references to R65.2:

Code Also: M35.81

ICD-10-CM Diagnosis Code M35.81
Multisystem inflammatory syndrome
Applicable To
- MIS-A
- MIS-C
- Multisystem inflammatory syndrome in adults
- Multisystem inflammatory syndrome in children
- Pediatric inflammatory multisystem syndrome
- PIMS
Code First
- , if applicable, COVID-19 (U07.1)
Code Also
- any associated complications such as:
- acute hepatic failure (K72.0-)
- acute kidney failure (N17.-)
- acute myocarditis (I40.-)
- acute respiratory distress syndrome (J80)
- cardiac arrhythmia (I47-I49.-)
- pneumonia due to COVID-19 (J12.82)
- severe sepsis (R65.2-)
- viral cardiomyopathy (B33.24)
- viral pericarditis (B33.23)
Use Additional
- code, if applicable, for:
- exposure to COVID-19 or SARS-CoV-2 infection (Z20.822)
- personal history of COVID-19 (Z86.16)
- post COVID-19 condition (U09.9)
Type 1 Excludes: R65.1

ICD-10-CM Diagnosis Code R65.1
Systemic inflammatory response syndrome (SIRS) of non-infectious origin
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)
Use Additional: P36

ICD-10-CM Diagnosis Code P36
Bacterial sepsis of newborn
Includes
- congenital sepsis
Use Additional
- code(s), if applicable, to identify severe sepsis (R65.2-) and associated acute organ dysfunction(s)

ICD-10-CM Codes Adjacent To R65.2

R63.39 Other 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

R68.2 Dry mouth, unspecified

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

2023 ICD-10-CM Diagnosis Code R65.2

Severe sepsis

Acute respiratory failure

Critical illness myopathy

Critical illness polyneuropathy

Disseminated intravascular coagulation [defibrination syndrome]

Metabolic encephalopathy

Acute and subacute hepatic failure

Infection following a procedure

Infections following infusion, transfusion and therapeutic injection

Puerperal sepsis

Sepsis following complete or unspecified spontaneous abortion

Sepsis following ectopic and molar pregnancy

Sepsis following incomplete spontaneous abortion

Sepsis following (induced) termination of pregnancy

Sepsis, unspecified organism

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

Multisystem inflammatory syndrome

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

Bacterial sepsis of newborn