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    v1.0.30
    OpenPayerBilling CodesGeneral symptoms and signsICD-10-CM r65-systemic-inflammation-and-infection
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    ICD-10-CM Code For Symptoms And Signs Specifically Associated With Systemic Inflammation And Infection: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group R65 includes diagnoses that describe systemic inflammatory responses and infection-related signs such as systemic inflammatory response syndrome and sepsis manifestations. These ICD-10-CM diagnosis codes are used to document clinical scenarios that capture disease severity, organ dysfunction, and systemic clinical complexity relevant to severe infection and inflammation. Accurate coding within the ICD-10-CM R65 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM R65: Symptoms And Signs Specifically Associated With Systemic Inflammation And Infection Overview

    This group captures clinical findings that reflect systemic inflammatory responses and severe infection-related signs rather than a specific localized disease. It covers manifestations such as systemic inflammatory response and sepsis-related presentations that affect multiple organ systems. Accurate coding of these signs is important because it communicates clinical severity and complexity, which impact claim adjudication and appropriate reimbursement.

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    When to Use

    Use a code from this group when the clinical record documents systemic inflammatory signs or sepsis-related manifestations without a more specific infectious etiology code. These codes are applied to capture severity and systemic involvement when documenting patient condition, organ dysfunction, or systemic inflammatory response.

    ICD-10-CM Codes

    4 rows

    ICD-10-CM CodeDescription
    R65.10Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction
    R65.11Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction
    R65.20Severe sepsis without septic shock
    R65.21Severe sepsis with septic shock

    DRG Codes

    4 rows

    DRG CodeDescription
    864Fever and Inflammatory Conditions
    870Septicemia or Severe Sepsis with MV >96 Hours
    871Septicemia or Severe Sepsis without MV >96 Hours with MCC
    872Septicemia or Severe Sepsis without MV >96 Hours without MCC

    Typical Clinical Scenarios

    • An elderly patient in the emergency department presents with fever, hypotension, tachycardia, and altered mental status after a urinary tract infection; initial labs show leukocytosis and elevated lactate, and the team documents systemic inflammatory response with organ dysfunction requiring fluid resuscitation and close monitoring. A diagnosis from this group is assigned to capture the acute systemic inflammatory state associated with suspected sepsis and organ dysfunction. Typical codes: R65.21, R65.11
    • A middle-aged patient recently hospitalized for severe pneumonia develops persistent high fevers, diffuse malaise, and increased respiratory support needs despite antibiotics; clinicians note a systemic inflammatory reaction without current shock but with signs of increased inflammatory burden and possible early organ dysfunction. A code from this group is used to characterize the systemic inflammatory syndrome complicating the infectious process and guide severity documentation. Typical codes: R65.20, R65.10
    • A frail nursing home resident with multiple comorbidities presents with subtle worsening functional status, low-grade fever, and borderline blood pressure; providers identify systemic inflammatory response without acute organ failure and document it as a comorbidity that complicates chronic care and influences clinical decisions. A group code is assigned to denote the presence of systemic inflammation as a significant comorbid condition. Typical codes: R65.10, R65.20

    Related Codes

    R50-FEVER-OF-OTHER-AND-UNKNOWN-ORIGIN

    ICD-10-CM Code For Fever Of Other And Unknown Origin: Group Overview

    R51-HEADACHE

    ICD-10-CM Code For Headache: Group Overview

    R52-PAIN-UNSPECIFIED

    ICD-10-CM Code For Pain Unspecified: Group Overview

    R53-MALAISE-AND-FATIGUE

    ICD-10-CM Code For Malaise And Fatigue: Group Overview

    R54-AGE-RELATED-PHYSICAL-DEBILITY

    ICD-10-CM Code For Age Related Physical Debility: Group Overview

    R55-SYNCOPE-AND-COLLAPSE

    ICD-10-CM Code For Syncope And Collapse: Group Overview

    R56-CONVULSIONS-NOT-ELSEWHERE-CLASSIFIED

    ICD-10-CM Code For Convulsions Not Elsewhere Classified: Group Overview

    R57-SHOCK-NOT-ELSEWHERE-CLASSIFIED

    ICD-10-CM Code For Shock Not Elsewhere Classified: Group Overview

    R58-HEMORRHAGE-NOT-ELSEWHERE-CLASSIFIED

    ICD-10-CM Code For Hemorrhage Not Elsewhere Classified: Group Overview

    R59-ENLARGED-LYMPH-NODES

    ICD-10-CM Code For Enlarged Lymph Nodes: Group Overview

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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