2027 ICD-10-CM Diagnosis Code T81.44XASepsis following a procedure, initial encounter

ICD-10-CM Codes›S00–T88›T80-T88›T81

ICD-10-CM T81.44XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

T81.44XA is a billable ICD-10-CM diagnosis code for sepsis following a procedure, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793, 856 through 858, 862 through 863. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 55 closely related codes. Coders also document this condition as postoperative sepsis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Complication of other surgical or medical care, injury, initial encounter; and Septicemia.

T81.44XA no longer risk-adjusts for Medicare Advantage: it mapped to HCC 2 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 2, ESRD (V21) category 2, and ESRD (V24) category 2 for payment year 2027.

Code Identity

ICD-10-CM Code
T81.44XA
Billable Status
Yes — Valid for Submission
Code Describes
Sepsis following a procedure, initial encounter
Short Description
Sepsis following a procedure, initial encounter
Same as the full description in the CMS dataset.
Parent Code
T81.44
Sepsis following a procedure

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT80-T88Complications of surgical and medical care, not elsewhere classified
CategoryT81Complications of procedures, not elsewhere classified
This CodeT81.44XASepsis following a procedure, initial encounter

Medicare Risk Adjustment (HCC)Billing

T81.44XA no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 2
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 2 · ESRD (V21): HCC 2 · ESRD (V24): HCC 2
ESRD V21 weights: 0.081 dialysis, 0.274–0.428 functioning graft · ESRD V24 weights: 0.087 dialysis, 0.270–0.532 functioning graft
Part D (RxHCC)
Not mapped
T81.44XA does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Postoperative sepsis
  • Post-splenectomy sepsis
  • Sepsis due to and following procedure
  • Sepsis in asplenic subject

Coding GuidelinesGuidance

The appropriate 7th character is to be added to each code from block Complications of procedures, not elsewhere classified (T81). Use the following options for the applicable episode of care:

  • A - initial encounter
  • D - subsequent encounter
  • S - sequela

Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T81.44XA: its own notes plus those printed at T81.44, T81.4, T81, block T80-T88, and Chapter 19. 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 T81.4 Infection following a procedure applies to 18 codes
  • 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)
From T81 Complications of procedures, not elsewhere classified applies to 240 codes
From Block T80-T88 Complications of surgical and medical care, not elsewhere classified applies to 1,683 codes
  • any encounters with medical care for postprocedural conditions in which no complications are present, such as:
  • artificial opening status (Z93.-)
  • closure of external stoma (Z43.-)
  • fitting and adjustment of external prosthetic device (Z44.-)
  • burns and corrosions from local applications and irradiation (T20-T32)
  • complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
  • mechanical complication of respirator [ventilator] (J95.850)
  • poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
  • postprocedural fever (R50.82)
  • specified complications classified elsewhere, such as:
  • cerebrospinal fluid leak from spinal puncture (G97.0)
  • colostomy malfunction (K94.0-)
  • disorders of fluid and electrolyte imbalance (E86-E87)
  • functional disturbances following cardiac surgery (I97.0-I97.1)
  • intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
  • ostomy complications (J95.0-, K94.-, N99.5-)
  • postgastric surgery syndromes (K91.1)
  • postlaminectomy syndrome NEC (M96.1)
  • postmastectomy lymphedema syndrome (I97.2)
  • postsurgical blind-loop syndrome (K91.2)
  • ventilator associated pneumonia (J95.851)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From T81.44 Sepsis following a procedure applies to 3 codes
  • code to identify the sepsis
From T81.4 Infection following a procedure applies to 18 codes
  • code to identify infection
  • code (R65.2-) to identify severe sepsis, if applicable
From T81 Complications of procedures, not elsewhere classified applies to 240 codes
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
From Block T80-T88 Complications of surgical and medical care, not elsewhere classified applies to 1,683 codes
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • code(s) to identify the specified condition resulting from the complication
  • code to identify devices involved and details of circumstances (Y62-Y82)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From T81.4 Infection following a procedure applies to 18 codes
  • if applicable, disruption of internal operation (surgical) wound (T81.32-)

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T81 Complications of procedures, not elsewhere classified applies to 240 codes
  • The appropriate 7th character is to be added to each code from category T81
Values for category T81 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T81.44XA, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming T81.44XA: they are not reported together with it, unless the two conditions are unrelated.

  • O86.0 Infection of obstetric surgical wound
    complications of procedures, not elsewhere classified (T81.4-) names T81.4-, which includes this code
  • R50.82 Postprocedural fever
    postprocedural infection (T81.4-) names T81.4-, which includes this code

Excludes2 3

These codes carry an Excludes2 note naming T81.44XA: its condition is not part of those codes, and both may be reported when the patient has both.

  • K68.11 Postprocedural retroperitoneal abscess
    infection following procedure (T81.4-) names T81.4-, which includes this code
  • T80.2 Infections following infusion, transfusion and therapeutic injection
    postprocedural infections (T81.4-) names T81.4-, which includes this code
  • T88 Other complications of surgical and medical care, not elsewhere classified
    complication following procedure NEC (T81.-) names T81.-, which includes this code

Code First 4

These codes say to code first a condition named in the note, and T81.44XA is one of the conditions named.

  • A40 Streptococcal sepsis
    if applicable, postprocedural sepsis (T81.44-) names T81.44-, which includes this code
  • A41 Other sepsis
    if applicable, postprocedural sepsis (T81.44-) names T81.44-, which includes this code
  • J98.51 Mediastinitis
    underlying condition, if applicable, such as postoperative mediastinitis (T81.-) names T81.-, which includes this code
  • R65.2 Severe sepsis
    infection following a procedure (T81.4-) names T81.4-, which includes this code

Clinical ClassificationClinical

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

CCSR INJ037
Complication of other surgical or medical care, injury, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INF002
Septicemia
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

After Surgery

After any operation, you'll have some side effects. There is usually some pain with surgery. There may also be swelling and soreness around the area that the surgeon cut. Your surgeon can tell you which side effects to expect.

Read the full article at MedlinePlus

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

Code History & ChangesHistory

Replacement T81.44XA replaces the following previously assigned code(s):

  • T81.4XXA - Infection following a procedure, initial encounter
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T81.44XAOverview

What is the ICD-10 code for sepsis following a procedure, initial encounter?

The ICD-10-CM code for sepsis following a procedure, initial encounter is T81.44XA (sometimes written as T8144XA). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is T81.44XA (Sepsis following a procedure) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report sepsis following a procedure, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character A in T81.44XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for sepsis following a procedure, such as an emergency visit or first evaluation.

What MS-DRG does T81.44XA group to?

When sepsis following a procedure, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 858, 856, 857, 863, 862, with relative weights from 0.9868 to 4.4822 depending on complications. Higher weights mean higher Medicare reimbursement.

Is T81.44XA a CC or MCC?

CMS lists T81.44XA as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 55 closely related codes in its exclusion list.

Does T81.44XA risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. T81.44XA mapped to HCC 2 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 2 (Septicemia/Sepsis/Systemic Inflammatory Response Syndrome/Shock), ESRD (V21) category 2 (Septicemia/Sepsis/Systemic Inflammatory Response Syndrome/Shock), and ESRD (V24) category 2 (Septicemia/Sepsis/Systemic Inflammatory Response Syndrome/Shock).