R65.20 Severe sepsis without septic shock

The ICD-10-CM code for Severe sepsis without septic shock is R65.20 (FY2026). It is a billable, claim-ready diagnosis code.

Classification

Chapter

18: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)

Section

R50-R69: General symptoms and signs (R50-R69)

Category R65

7 codes (4 billable)

FY2026 Status

Stable since FY2024

Also Known As

ICD-10-CM Alphabetic Index entries that lead to R65.20:

• Severe sepsis
• Sepsis (generalized) (unspecified organism) › severe
• Infection, infected, infective (opportunistic) › with › organ dysfunction (acute)
• Sepsis (generalized) (unspecified organism) › with › organ dysfunction (acute) (multiple)

Inclusion Terms

• Severe sepsis NOS

U.S. Hospital Utilization

• An estimated 632,840 U.S. inpatient stays in 2023 included R65.20 among the documented diagnoses.
• 65 stays listed it as the principal diagnosis.

Source: National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality, 2016–2023. National survey-weighted estimates.

Official Coding Guidelines

P36 default congenital; organism add-on rules; severe sepsis coding

f. Bacterial Sepsis of Newborn Category P36, Bacterial sepsis of newborn, includes congenital sepsis. If a perinate is documented as having sepsis without documentation of congenital or community acquired, the default is congenital and a code from category P36 should be assigned. If the P36 code includes the causal organism, an additional code from category B95, Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere, or B96, Other bacterial agents as the cause of diseases classified elsewhere, should not be assigned. If the P36 code does not include the causal organism, assign an additional code from category B96. If applicable, use additional codes to identify severe sepsis (R65.2-) and any associated acute organ dysfunction.

Puerperal sepsis: use O85 + organism; don't use A40/A41; add R65.2- etc if applicable

k. Puerperal sepsis Code O85, Puerperal sepsis, should be assigned with a secondary code to identify the causal organism (e.g., for a bacterial infection, assign a code from category B95-B96, Bacterial infections in conditions classified elsewhere). A code from category A40, Streptococcal sepsis, or A41, Other sepsis, should not be used for puerperal sepsis. If applicable, use additional codes to identify severe sepsis (R65.2-) and any associated acute organ dysfunction.

Source: CMS — ICD-10-CM Official Guidelines for Coding and Reporting, FY2026

References

• CMS — ICD-10-CM Official Code Set and Guidelines, FY2026
• CDC/NCHS — ICD-10-CM Files and Browser Tool
• AHRQ — HCUP National Inpatient Sample, Frequencies by Diagnosis Code (2016–2023)