R65.20 - Severe sepsis without septic shock
|Short Description:||Severe sepsis without septic shock|
|Long Description:||Severe sepsis without septic shock|
|Status:||Valid for Submission|
R65.20 is a billable ICD-10 code used to specify a medical diagnosis of severe sepsis without septic shock. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Sepsis caused by Meningococcus
- Sepsis caused by methicillin susceptible Staphylococcus aureus
- Sepsis syndrome
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to this diagnosis code:
Inclusion TermsInclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Severe sepsis NOS
Index to Diseases and Injuries References
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for this diagnosis code are found in the injuries and diseases index:
- - Infection, infected, infective (opportunistic) - B99.9
- - with
- - organ dysfunction (acute) - R65.20
- - with
- - Sepsis (generalized) (unspecified organism) - A41.9
- - with
- - organ dysfunction (acute) (multiple) - R65.20
- - severe - R65.20
- - with
- - Severe sepsis - R65.20
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Convert to ICD-9 Code
|Source ICD-10 Code||Target ICD-9 Code|
|R65.20||995.92 - Severe sepsis|
|Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.|
What is sepsis?
Sepsis is your body's overactive and extreme response to an infection. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage, organ failure, and even death.
What causes sepsis?
Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Bacterial infections are the most common cause, but other types of infections can also cause it.
The infections are often in the lungs, stomach, kidneys, or bladder. It's possible for sepsis to begin with a small cut that gets infected or with an infection that develops after surgery. Sometimes, sepsis can occur in people who didn't even know that they had an infection.
Who is at risk for sepsis?
Anyone with an infection could get sepsis. But certain people are at higher risk:
- Adults 65 or older
- People with chronic conditions, such as diabetes, lung disease, cancer, and kidney disease
- People with weakened immune systems
- Pregnant women
- Children younger than one
What are the symptoms of sepsis?
Sepsis can cause one or more of these symptoms:
- Rapid breathing and heart rate
- Shortness of breath
- Confusion or disorientation
- Extreme pain or discomfort
- Fever, shivering, or feeling very cold
- Clammy or sweaty skin
It's important to get medical care right away if you think you might have sepsis or if your infection is not getting better or is getting worse.
What other problems can sepsis cause?
Severe cases of sepsis can lead to septic shock, where your blood pressure drops to a dangerous level and multiple organs can fail.
How is sepsis diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms
- A physical exam, including checking vital signs (your temperature, blood pressure, heart rate, and breathing)
- Lab tests that check for signs of infection or organ damage
- Imaging tests such as an x-ray or a CT scan to find the location of the infection
Many of the signs and symptoms of sepsis can also be caused by other medical conditions. This may make sepsis hard to diagnose in its early stages.
What are the treatments for sepsis?
It is very important to get treatment right away. Treatment usually includes:
- Maintaining blood flow to organs. This may involve getting oxygen and intravenous (IV) fluids.
- Treating the source of the infection
- If needed, medicines to increase blood pressure
In serious cases, you might need kidney dialysis or a breathing tube. Some people need surgery to remove tissue damaged by the infection.
Can sepsis be prevented?
To prevent sepsis, you should try to prevent getting an infection:
- Take good care of any chronic health conditions that you have
- Get recommended vaccines
- Practice good hygiene, such as handwashing
- Keep cuts clean and covered until healed
NIH: National Institute of General Medical SciencesCenters for Disease Control and Prevention
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- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)