ICD-10 code for severe sepsis

The ICD-10-CM code for severe sepsis is R65.20 (Severe sepsis without 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 R65.20.

Within R65.2, choose R65.20 (without septic shock) only when documentation doesn't support a more specific option: with septic shock (R65.21).

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.

In MS-DRG v44.0, it is part of the grouping logic for DRG 870 (Septicemia or Severe Sepsis with MV >96 Hours, relative weight 6.9408), DRG 871 (Septicemia or Severe Sepsis without MV >96 Hours with MCC, relative weight 1.932) and DRG 872 (Septicemia or Severe Sepsis without MV >96 Hours without MCC, relative weight 1.0066), in MDC 18 (Infectious and Parasitic Diseases, Systemic or Unspecified Sites), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.