R65.20
R65.20: Severe sepsis without septic shock
Billable / specific codeICD-10-CM
R65.20 is a billable, specific ICD-10-CM code for severe sepsis without septic shock. It is valid for submission on a claim.
Check R65.20 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Severe sepsis NOS
Risk adjustment
R65.20 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
R65.20 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A56809Billing and Coding: Transesophageal Echocardiography (TEE)
- A57326Billing and Coding: Electrocardiograms
- A58710Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Alphabetic index entries that lead here
- Severe sepsis
- Sepsis›severe
- Infection, infected, infective›with›organ dysfunction(acute)
- Sepsis›with›organ dysfunction(acute) (multiple)
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.