2026 ICD-10-CM Diagnosis Code R65.20Severe sepsis without septic shock

ICD-10-CM Codes›R00–R99›R50-R69›R65

ICD-10-CM R65.20
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

R65.20 is a billable ICD-10-CM diagnosis code for severe sepsis without septic shock. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 870 through 872. The code is not accepted as a principal diagnosis by the Medicare Code Editor. As a symptom code, it should not be used as a principal diagnosis once a related definitive diagnosis has been established. Coders also document this condition as sepsis caused by Meningococcus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Septicemia.

Code Identity

ICD-10-CM Code
R65.20
Billable Status
Yes — Valid for Submission
Code Describes
Severe sepsis without septic shock
Short Description
Severe sepsis without septic shock
Same as the full description in the CMS dataset.
Parent Code
R65.2
Severe sepsis

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 CodeR65.20Severe sepsis without septic shock

Code EditsBilling

Medicare Code Editor checks that affect claim validity for R65.20.

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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Sepsis caused by Meningococcus
  • Sepsis caused by methicillin susceptible Staphylococcus aureus
  • Sepsis syndrome

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Severe sepsis NOS

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Infection, infected, infective(opportunistic)
      • with
        • organ dysfunction (acute)
    • Sepsis(generalized) (unspecified organism)
      • with
        • organ dysfunction (acute) (multiple)
    • Sepsis(generalized) (unspecified organism)
      • severe
    • Severe sepsis

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INF002
Septicemia
Default principal diagnosis: inpatient No · outpatient Yes

Patient EducationClinical

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.

The full article covers:

  • What is sepsis?
  • What causes sepsis?
  • Who is more likely to develop sepsis?
  • What are the symptoms of sepsis?
  • What other problems can sepsis cause?
  • How is sepsis diagnosed?
  • What are the treatments for sepsis?
  • Can sepsis be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert R65.20 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
995.92 Severe sepsis
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About R65.20Overview

Is R65.20 (Severe sepsis) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report severe sepsis without septic shock on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does R65.20 group to?

On inpatient claims, severe sepsis without septic shock maps to MS-DRG 870, 871, 872, with relative weights from 1.0233 to 6.9118 depending on complications. Higher weights mean higher Medicare reimbursement.

Can R65.20 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because severe sepsis without septic shock describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

What is the ICD-9 equivalent of R65.20?

Under the General Equivalence Mappings, severe sepsis without septic shock converts to ICD-9-CM 995.92 (severe sepsis). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.