R65.21 – Severe sepsis with septic shock

ICD-10-CM 2027 diagnosis code · General symptoms and signs

Billable code

ICD-10-CM code R65.21

Code: R65.21 (claims format: R6521)
Description: Severe sepsis with septic shock
Billable: Yes – valid for HIPAA-covered transactions
Valid for: Dates of service October 1, 2026 – September 30, 2027 (FY2027)
Chapter: 18. Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
Block: R50-R69 General symptoms and signs
Parent codes: R65 › R65.2

Notes for R65.21

Excludes1 (not coded here):

postprocedural septic shock (T81.12-)

Notes inherited from parent codes

Instructional notes at a category or block level apply to every code below it.

R65.2 – Severe sepsis

Applicable to:

Infection with associated acute organ dysfunction
Sepsis with acute organ dysfunction
Sepsis with multiple organ dysfunction
Systemic inflammatory response syndrome due to infectious process with acute organ dysfunction

Code first:

underlying infection, such as:
infection following a procedure (T81.4-)
infections following infusion, transfusion and therapeutic injection (T80.2-)
puerperal sepsis (O85)
sepsis following complete or unspecified spontaneous abortion (O03.87)
sepsis following ectopic and molar pregnancy (O08.82)
sepsis following incomplete spontaneous abortion (O03.37)
sepsis following (induced) termination of pregnancy (O04.87)
sepsis NOS (A41.9)

Use additional code:

code to identify specific acute organ dysfunction, such as:
acute kidney failure (N17.-)
acute respiratory failure (J96.0-)
critical illness myopathy (G72.81)
critical illness polyneuropathy (G62.81)
disseminated intravascular coagulopathy [DIC] (D65)
encephalopathy (metabolic) (septic) (G93.41)
hepatic failure (K72.0-)

Index terms for R65.21

Entries in the ICD-10-CM alphabetic index that lead to this code:

Related codes in R65.2

R65.20 – Severe sepsis without septic shockBillable

Frequently asked questions

What is ICD-10 code R65.21?

R65.21 is the ICD-10-CM code for severe sepsis with septic shock, in the block R50-R69 (General symptoms and signs).

Is R65.21 a billable code?

Yes. R65.21 is a billable/specific code that can be used to indicate a diagnosis for reimbursement purposes.

What category does R65.21 belong to?

It belongs to category R65 – Symptoms and signs specifically associated with systemic inflammation and infection.

Source: CDC/NCHS ICD-10-CM FY2027 code files, tabular list and index. Reference only – code assignment must follow the official ICD-10-CM guidelines and documentation in the medical record.