R65.11: Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction
R65.11 is a billable, specific ICD-10-CM code for systemic inflammatory response syndrome (sirs) of non-infectious origin with acute organ dysfunction. It is valid for submission on a claim.
Check R65.11 with the rest of the claim: free scrubberUse additional code
Add a secondary code to capture the detail described below.
- code to identify specific acute organ dysfunction, such as:
- acute kidney failure (N17.-)
- acute respiratory failure (J96.0-)
- critical illness myopathy (G72.81)
- critical illness polyneuropathy (G62.81)
- disseminated intravascular coagulopathy [DIC] (D65)
- encephalopathy (metabolic) (septic) (G93.41)
- hepatic failure (K72.0-)
Risk adjustment
R65.11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock0.500 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
R65.11 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57326Billing and Coding: Electrocardiograms
Alphabetic index entries that lead here
- Syndrome›systemic inflammatory response›with acute organ dysfunction
- System, systemic›inflammatory response syndrome›with acute organ dysfunction
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.