ICD-10-CM Codes
R00-R99
R50-R69
R65-
2023 ICD-10-CM Diagnosis Code R65.21

2023 ICD-10-CM Diagnosis Code R65.21

Severe sepsis with septic shock

2016

2017

2018

2019

2020

2021

2022

2023

Billable/Specific Code

R65.21 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
The 2023 edition of ICD-10-CM R65.21 became effective on October 1, 2022.
This is the American ICD-10-CM version of R65.21 - other international versions of ICD-10 R65.21 may differ.

The following code(s) above R65.21 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 R65.21:

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
R65.2
ICD-10-CM Diagnosis Code R65.2
Severe sepsis
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
Code First
- underlying infection, such as:
- infection following a procedure (T81.4-)
- infections following infusion, transfusion and therapeutic injection (T80.2-)
- puerperal sepsis (O85)
- sepsis following complete or unspecified spontaneous abortion (O03.87)
- sepsis following ectopic and molar pregnancy (O08.82)
- sepsis following incomplete spontaneous abortion (O03.37)
- sepsis following (induced) termination of pregnancy (O04.87)
- sepsis NOS (A41.9)
Use Additional
- code to identify specific acute organ dysfunction, such as:
- acute kidney failure (N17.-)
- acute respiratory failure (J96.0-)
- critical illness myopathy (G72.81)
- critical illness polyneuropathy (G62.81)
- disseminated intravascular coagulopathy [DIC] (D65)
- encephalopathy (metabolic) (septic) (G93.41)
- hepatic failure (K72.0-)
Severe sepsis

Approximate Synonyms

Septic shock
Septic shock acute organ dysfunction
Septic shock acute organ dysfunction, anaerobic
Septic shock acute organ dysfunction, escherichia coli
Septic shock acute organ dysfunction, gram negative
Septic shock acute organ dysfunction, meningococcal
Septic shock acute organ dysfunction, mrsa
Septic shock acute organ dysfunction, pseudomonas
Septic shock acute organ dysfunction, salmonella
Septic shock acute organ dysfunction, serratia
Septic shock acute organ dysfunction, staphylococcus
Septic shock acute organ dysfunction, streptococcal
Septic shock due to hemophilus influenza septicemia with acute organ dysfunction
Septic shock due to methicillin susceptible staphylococcus aureus septicemia with acute organ dysfunction
Septic shock due to salmonella with acute organ dysfunction
Septic shock due to staphylococcal septicemia with acute organ dysfunction, final identification pending
Septic shock organ dysfunction, hemophilus influenza
Septic shock with acute organ dysfunction
Septic shock with acute organ dysfunction due to anaerobic septicemia
Septic shock with acute organ dysfunction due to chromobacterium
Septic shock with acute organ dysfunction due to coagulate-negative staphylococcu
Septic shock with acute organ dysfunction due to enterococcus
Septic shock with acute organ dysfunction due to escherichia coli septicemia
Septic shock with acute organ dysfunction due to gonococcus
Septic shock with acute organ dysfunction due to gram negative septicemia
Septic shock with acute organ dysfunction due to gram positive coccus
Septic shock with acute organ dysfunction due to group a streptococcus
Septic shock with acute organ dysfunction due to group b streptococcus
Septic shock with acute organ dysfunction due to meningococcal septicemia
Septic shock with acute organ dysfunction due to methicillin resistant staphylococcus aureus septicemia
Septic shock with acute organ dysfunction due to pneumococcal septicemia
Septic shock with acute organ dysfunction due to pseudomonas septicemia
Septic shock with acute organ dysfunction due to septicemia, final identification pending
Septic shock with acute organ dysfunction due to serratia septicemia
Septic shock with acute organ dysfunction due to streptococcal septicemia

ICD-10-CM R65.21 is grouped within Diagnostic Related Group(s) (MS-DRG v40.0):

870 Septicemia or severe sepsis with mv >96 hours
871 Septicemia or severe sepsis without mv >96 hours with mcc
872 Septicemia or severe sepsis without mv >96 hours without mcc

Convert R65.21 to ICD-9-CM

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 R65.21:

Type 1 Excludes: T79.4
, T81.1

ICD-10-CM Diagnosis Code T79.4
Traumatic shock
Applicable To
- Shock (immediate) (delayed) following injury
Type 1 Excludes
- anaphylactic shock due to adverse food reaction (T78.0-)
- anaphylactic shock due to correct medicinal substance properly administered (T88.6)
- anaphylactic shock due to serum (T80.5-)
- anaphylactic shock NOS (T78.2)
- electric shock (T75.4)
- nontraumatic shock NEC (R57.-)
- obstetric shock (O75.1)
- postprocedural shock (T81.1-)
- septic shock (R65.21)
- shock complicating abortion or ectopic or molar pregnancy (O00-O07, O08.3)
- shock due to anesthesia (T88.2)
- shock due to lightning (T75.01)
- shock NOS (R57.9)
ICD-10-CM Diagnosis Code T81.1
Postprocedural shock
Applicable To
- Shock during or resulting from a procedure, not elsewhere classified
Type 1 Excludes
- anaphylactic shock NOS (T78.2)
- anaphylactic shock due to correct substance properly administered (T88.6)
- anaphylactic shock due to serum (T80.5-)
- electric shock (T75.4)
- obstetric shock (O75.1)
- septic shock (R65.21)
- shock due to anesthesia (T88.2)
- shock following abortion or ectopic or molar pregnancy (O00-O07, O08.3)
- traumatic shock (T79.4)
Type 2 Excludes: R57.0

ICD-10-CM Diagnosis Code R57.0
Cardiogenic shock
Type 2 Excludes
- septic shock (R65.21)

Diagnosis Index entries containing back-references to R65.21:

Infection, infected, infective (opportunistic) B99.9
ICD-10-CM Diagnosis Code B99.9
Unspecified infectious disease
- with
  - organ dysfunction (acute) R65.20
    ICD-10-CM Diagnosis Code R65.20
    Severe sepsis without septic shock
    2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code
    Applicable To
    Severe sepsis NOS
    - with septic shock R65.21
Sepsis (generalized) (unspecified organism) A41.9
ICD-10-CM Diagnosis Code A41.9
Sepsis, unspecified organism
Applicable To
Septicemia NOS
- with
  - organ dysfunction (acute) (multiple) R65.20
    ICD-10-CM Diagnosis Code R65.20
    Severe sepsis without septic shock
    2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code
    Applicable To
    Severe sepsis NOS
    - with septic shock R65.21
- severe R65.20
  ICD-10-CM Diagnosis Code R65.20
  Severe sepsis without septic shock
  2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code
  Applicable To
  Severe sepsis NOS
  - with septic shock R65.21
Severe sepsis R65.20
ICD-10-CM Diagnosis Code R65.20
Severe sepsis without septic shock
Applicable To
Severe sepsis NOS
- with septic shock R65.21
Shock R57.9
ICD-10-CM Diagnosis Code R57.9
Shock, unspecified
Applicable To
Failure of peripheral circulation NOS
- endotoxic R65.21
- gram-negative R65.21
- septic R65.21 (due to severe sepsis)

ICD-10-CM Codes Adjacent To R65.21

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

R68.3 Clubbing of fingers

R68.8 Other general symptoms and signs

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 R65.21

Severe sepsis with septic shock

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

Severe sepsis

Traumatic shock

Postprocedural shock

Cardiogenic shock

Unspecified infectious disease

Severe sepsis without septic shock

Sepsis, unspecified organism

Severe sepsis without septic shock

Severe sepsis without septic shock

Severe sepsis without septic shock

Shock, unspecified