Sepsis ICD-10-CM Codes | 2023

What ICD-10 Codes are Used for Sepsis?

Below are lists of commonly used ICD Codes for Sepsis depending on the bacteria that caused the sepsis:

Streptococci

• A40: Streptococcal sepsis
• A40.0 and A40.1: Sepsis due to streptococcus group A and Sepsis due to streptococcus, group B
• A40.3: Sepsis due to Streptococcus pneumoniae
• A40.8 and A40.9: Other streptococcal sepsis and Streptococcal sepsis, unspecified

Staphylococcus aureus

• A41.0: Sepsis due to Staphylococcus aureus 
• A41.01 and A41.02: Sepsis due to Methicillin susceptible Staphylococcus aureus and Sepsis due to Methicillin resistent Staphylococcus aureus

Staphylococcus

• A41.1 and A41.2: Sepsis due to other specified staphylococcus and Sepsis due to unspecified staphylococcus
• A41.3: Sepsis Hemophilus influenza
• Sepsis due to anaerobes

Gram-negative organisms

• A41.5: Sepsis due to other Gram-negative organisms
• A41.50 Gram-negative sepsis, unspecified
• A41.51: Sepsis due to Escherichia coli 
• A41.52: Sepsis due to Pseudomonas
• A41.53: Sepsis due to Serratia
• A41.59: Other Gram-negative sepsis

Other Organisms

• A41.8: Other specified sepsis
• A41.81: Sepsis due to Enterococcus
• A41.89 Other specified Sepsis
• A41.9: Sepsis, unspecified organism

Aside from the ICD Codes mentioned above, we’ll also provide the list of ICD codes for severe sepsis:

• R65.2: Severe sepsis
• R65.20: Severe sepsis without septic shock
• R65.21: Severe sepsis with septic shock

Do note that ICD codes for severe sepsis cannot be used alone. Practitioners must first select the cause, whether by an organism or not, and then may they only use one of the codes for severe sepsis.

Which Sepsis ICD codes are Billable?

The following codes aren’t billable because they are not specific and not valid for the fiscal year of 2023: A40, A41.0, A41.5, A41.8, and R65.2. 

The other codes mentioned in the first section are billable because their causes are specified.

Clinical Information

• Sepsis is a life-threatening illness caused by an infection that triggered an extreme response in the immune system. 
• It has three stages: sepsis, severe sepsis, and septic shock.
• Signs and symptoms of sepsis are fever, hypotension or a fast heart rate, confusion, difficulty breathing, extreme pain, and sweaty skin. On the other hand, signs and symptoms of severe sepsis will be a combination of the ones they’re experiencing during sepsis and others, such as asthenia, thrombocytopenia, unconsciousness, bluish skin discoloration, dizziness, decreased urination, etc. When a patient has septic shock, in addition to the signs and symptoms of severe sepsis, one of the critical symptoms the patient will experience is extremely low blood pressure. 
• Bacteria are the most common cause of sepsis. However, particular viruses can also cause infection.
• Although anyone is susceptible to sepsis, those with a higher risk of infection are people undergoing chemotherapy, have HIV, are in ICUs, and have invasive devices like catheters or breathing tubes. Young children and seniors are also highly susceptible to infections. 
• One diagnosis of sepsis is by checking if the patient has symptoms of sepsis. If they do, the patient will undergo a blood test and, if needed, a urine test, wound/mucus secretion test, and imaging tests like x-rays, CT scans, ultrasounds, and MRI scans. 
• The severity of sepsis depends on whether it hits the criteria of systemic inflammatory response syndrome (SIRS) or quick sequential organ failure assessment (qSOFA). 
• Treatments for sepsis include antibiotics, medication, pain relievers, insulin, and sometimes dialysis or surgery.

Synonyms Include:

• Bacterial sepsis
• Systemic inflammatory response syndrome
• Clinical sepsis
• Clinical infection
• Sepsis without septic shock