R65.20 — Severe sepsis without septic shock
R65.20 is a billable, specific ICD-10-CM code for severe sepsis without septic shock. It is valid for submission on a claim.
Inclusion 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.
Medicare coverage
R65.20 is named in 21 Medicare coverage policies — 21 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How R65.20 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to R65.20.
- Severe sepsis
- Sepsis›severe
- Infection, infected, infective›with›organ dysfunction(acute)
- Sepsis›with›organ dysfunction(acute) (multiple)
Related codes at this level
Codes that share R65.2. If R65.20 is not quite right, the correct code is usually one of these.
Questions about R65.20
- Is R65.20 a billable ICD-10-CM code?
- Yes. R65.20 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does R65.20 sit in the tabular list?
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block General symptoms and signs (R50-R69).