2027 ICD-10-CM Diagnosis Code R65Symptoms and signs specifically associated with systemic inflammation and infection

ICD-10-CM Codes›R00–R99›R50-R69›R65

ICD-10-CM R65
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

R65 is a non-billable ICD-10-CM category code for symptoms and signs specifically associated with systemic inflammation and infection, so it cannot be submitted on claims. Use a more specific code from this category instead, such as R65.10, R65.11, R65.20, and R65.21. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established.

Code Identity

ICD-10-CM Code
R65
Billable Status
No — Non-Billable Category
Code Describes
Symptoms and signs specifically associated with systemic inflammation and infection
Short Description
Symp and signs specifically assoc w sys inflam and infct
Chapter
R50-R69
General symptoms and signs

Code Classification

ChapterR00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
SectionR50-R69General symptoms and signs
CategoryR65Symptoms and signs specifically associated with systemic inflammation and infection
This CodeR65Symptoms and signs specifically associated with systemic inflammation and infection

Specific Coding for Symp and signs specifically assoc w sys inflam and infctOverview

Non-specific codes like R65 require more characters. Use one of these billable codes instead:

  • R65.1 for Systemic inflammatory response syndrome (SIRS) of non-infectious origin

  • Use R65.10 for Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction

  • Use R65.11 for Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction

  • R65.2 for Severe sepsis

  • Use R65.20 for Severe sepsis without septic shock

  • Use R65.21 for Severe sepsis with septic shock

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to R65: its own notes plus those printed at Chapter 18. A note printed at a category, block or chapter applies to every code under it.

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • 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)

Notes

General instructions on how these codes are used.

From Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
  • 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.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About R65Overview

Is R65 a billable code?

No. This is a category header that groups the codes for symptoms and signs specifically associated with systemic inflammation and infection, and headers cannot be submitted on claims. Claims for symptoms and signs specifically associated with systemic inflammation and infection need a more specific code from this category, such as R65.10, R65.11, and R65.20.

Can R65 be a principal diagnosis?

Use it with care. This is a symptom code, so once a definitive diagnosis explaining the symptoms and signs specifically associated with systemic inflammation and infection is established, that condition takes the principal position instead.