Is R65.1 a billable ICD-10-CM code?

No. R65.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does R65.1 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block General symptoms and signs (R50-R69).

What cannot be coded together with R65.1?

R65.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

R65.1

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

Non-billable headerICD-10-CM

R65.1 is a non-billable header ICD-10-CM code for systemic inflammatory response syndrome (sirs) of non-infectious origin. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

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

Code first

The underlying condition must be sequenced before this code.

underlying condition, such as:
heatstroke (T67.0-)
injury and trauma (S00-T88)

Risk adjustment

R65.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead R65.1

2 child codes. Green means billable.

Related codes at this level

Codes that share R65. If R65.1 is not quite right, the correct code is usually one of these.

R65.2Severe sepsis

Questions about R65.1

Is R65.1 a billable ICD-10-CM code?: No. R65.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does R65.1 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block General symptoms and signs (R50-R69).
What cannot be coded together with R65.1?: R65.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.