DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

Category · FY2027

R65 Symptoms and signs specifically associated with systemic inflammation and infection

  • Header · not billable

R65 is not billable. The category heads 4 billable codes in FY2027, grouped under 2 subdivisions.

Index → code

Where it sits

  1. Chapter 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
  2. R50-R69 General symptoms and signs (R50-R69)
  3. R65 Symptoms and signs specifically associated with systemic inflammation and infection
Billable codes
4
Subdivisions
2
CC / MCC codes
1 / 3
HCC V28 codes
4
New FY2027
0
Index entries
15

Codes in R65

  1. R65.1
    Systemic inflammatory response syndrome (SIRS) of non-infectious origin
    Header
    Excludes1 2, Code first 3

    Excludes1

    • sepsis- code to infection
    • severe sepsis (R65.2) R65.2

    Code first

    • underlying condition, such as:
    • heatstroke (T67.0-) T67.0
    • injury and trauma (S00-T88) S00 T88
  2. R65.10
    Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction
    BillableCC2
    Inclusion terms 1

    Inclusion terms

    • Systemic inflammatory response syndrome (SIRS) NOS
  3. R65.11
    Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction
    BillableMCC2
    Use additional code 8

    Use additional code

    • code to identify specific acute organ dysfunction, such as:
    • acute kidney failure (N17.-) N17
    • acute respiratory failure (J96.0-) J96.0
    • critical illness myopathy (G72.81) G72.81
    • critical illness polyneuropathy (G62.81) G62.81
    • disseminated intravascular coagulopathy [DIC] (D65) D65
    • encephalopathy (metabolic) (septic) (G93.41) G93.41
    • hepatic failure (K72.0-) K72.0
  4. R65.2
    Severe sepsis
    Header
    Inclusion terms 4, Code first 9, Use additional code 8

    Inclusion terms

    • 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-) T81.4
    • infections following infusion, transfusion and therapeutic injection (T80.2-) T80.2
    • puerperal sepsis (O85) O85
    • sepsis following complete or unspecified spontaneous abortion (O03.87) O03.87
    • sepsis following ectopic and molar pregnancy (O08.82) O08.82
    • sepsis following incomplete spontaneous abortion (O03.37) O03.37
    • sepsis following (induced) termination of pregnancy (O04.87) O04.87
    • sepsis NOS (A41.9) A41.9

    Use additional code

    • code to identify specific acute organ dysfunction, such as:
    • acute kidney failure (N17.-) N17
    • acute respiratory failure (J96.0-) J96.0
    • critical illness myopathy (G72.81) G72.81
    • critical illness polyneuropathy (G62.81) G62.81
    • disseminated intravascular coagulopathy [DIC] (D65) D65
    • encephalopathy (metabolic) (septic) (G93.41) G93.41
    • hepatic failure (K72.0-) K72.0
  5. R65.20
    Severe sepsis without septic shock
    BillableMCC2
    Inclusion terms 1

    Inclusion terms

    • Severe sepsis NOS
  6. R65.21
    Severe sepsis with septic shock
    BillableMCC2
    Excludes1 1

    Excludes1

    • postprocedural septic shock (T81.12-) T81.12

CC/MCC: as a secondary diagnosis, unless the principal diagnosis is on the code’s PDX exclusion list (MS-DRG v44 Appendix C; list on the code card).

Sources of each column.

Instructions

Notes that also apply

Chapter 18 instructions (Notes 9, Excludes2 4): printed on the chapter 18 page.

Index entries

  • Severe sepsis → R65.20
  • Syndromesystemic inflammatory response (SIRS), of non-infectious origin (without organ dysfunction) → R65.10
  • System, systemicinflammatory response syndrome (SIRS) of non-infectious origin (without organ dysfunction) → R65.10
  • Sepsis (generalized) (unspecified organism)severe → R65.20
  • Severe sepsiswith septic shock → R65.21
  • Shockendotoxic → R65.21
  • Shockgram-negative → R65.21
  • Shockseptic (due to severe sepsis) → R65.21
  • Syndromesystemic inflammatory response (SIRS), of non-infectious origin (without organ dysfunction)with acute organ dysfunction → R65.11
  • System, systemicinflammatory response syndrome (SIRS) of non-infectious origin (without organ dysfunction)with acute organ dysfunction → R65.11
  • Infection, infected, infective (opportunistic)withorgan dysfunction (acute) → R65.20
  • Sepsis (generalized) (unspecified organism)withorgan dysfunction (acute) (multiple) → R65.20
  • Sepsis (generalized) (unspecified organism)severewith septic shock → R65.21
  • Infection, infected, infective (opportunistic)withorgan dysfunction (acute)with septic shock → R65.21
  • Sepsis (generalized) (unspecified organism)withorgan dysfunction (acute) (multiple)with septic shock → R65.21

NCHS Alphabetic Index. Index first, then the Tabular List.

Hierarchy