ICD-10-CM 2027
ICD-10 code for Endotoxic shock
Severe sepsis with septic shock
From the official ICD-10-CM alphabetic index entry “Shock › endotoxic”. Page updated September 29, 2026.
About coding Endotoxic shock
The ICD-10-CM code for Endotoxic shock is R65.21 (Severe sepsis with septic shock). The official index lists 1 more specific code, so check the documentation for details such as type, cause, site or severity before settling on R65.21.
Within R65.2 (severe sepsis), R65.21 is specifically for severe sepsis with septic shock. Related codes cover without septic shock (R65.20).
Don't report R65.21 together with the conditions in its Excludes1 note: postprocedural septic shock (T81.12-).
As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.
More specific Endotoxic shock codes (official index)
- postprocedural (resulting from a procedure, not elsewhere classified) T81.12 — Postprocedural septic shock
Don't confuse with (Excludes1 for R65.21)
- postprocedural septic shock (T81.12-)
Common questions about Endotoxic shock ICD-10 codes
What is the ICD-10 code for Endotoxic shock?
- R65.21 — Severe sepsis with septic shock. More specific codes apply when the documentation supports them: T81.12.
What is the ICD-10 code for postprocedural endotoxic shock?
- T81.12 — Postprocedural septic shock (header code; choose a more specific subcode).
Is R65.21 billable?
- Yes. R65.21 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).
Can R65.21 be used as a principal diagnosis?
- No. It is not acceptable as the principal diagnosis for an inpatient stay; it may be reported as a secondary diagnosis.
Is R65.21 a CC or MCC?
- R65.21 is an MCC (major complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.