Sepsis, unspecified organism. A41.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM A41.9 became effective on October 1, 2018.
How do you code sepsis? The coding of severe sepsis requires a minimum of two codes: first a code for the underlying systemic infection, followed by a code from subcategory R65. 2, Severe sepsis. If the causal organism is not documented, assign code A41. 9, Sepsis, unspecified organism, for the infection.
• Septic shock – Code first the underlying systemic infection, such as 038.0 (Streptococcal septicemia), then code 995.92 for severe sepsis, then code 785.52 for septic shock and finally assign the code for the specific type of organ failure inherent to septic shock, such as 584.9 for acute renal failure.
ICD-10 code A41. 9 for Sepsis, unspecified organism is a medical classification as listed by WHO under the range - Certain infectious and parasitic diseases .
Coding sepsis requires a minimum of two codes: a code for the systemic infection (e.g., 038. xx) and the code 995.91, SIRS due to infectious process without organ dysfunction. If no causal organism is documented within the medical record, query the physician or assign code 038.9, Unspecified septicemia.
According to the guidelines above, sepsis would be the appropriate principal diagnosis if it is the reason the patient is admitted, and meets the definition of principal diagnosis.
ICD-10 code R65. 21 for Severe sepsis with septic shock is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
9: Fever, unspecified.
1. d.a states that R65. 2- can be coded when severe sepsis or an associated organ dysfunction is documented. If “severe sepsis” is documented without mention of organ dysfunction, R65.
0-, Infection following immunization, should be coded first, followed by the code for the specific infection. If the patient has severe sepsis, the appropriate code from subcategory R65. 2 should also be assigned, with the additional codes(s) for any acute organ dysfunction.
For septic shock, the code for the underlying infection should be sequenced first, followed by code R65. 21, Severe sepsis with septic shock or code T81. 12, Postprocedural septic shock. Additional codes are also required to report other acute organ dysfunctions.
Urosepsis isn't sepsis—not from a coding standpoint, at least. Unless you want a query, don't document it. If it was a urinary tract infection (UTI), then document that. If it was sepsis due to a UTI, please say that in your documentation.
Systemic disease associated with the presence of pathogenic microorganisms or their toxins in the blood. The presence of pathogenic microorganisms in the blood stream causing a rapidly progressing systemic reaction that may lead to shock. Symptoms include fever, chills, tachycardia, and increased respiratory rate.
Urosepsis . Clinical Information. (sep-sis) the presence of bacteria or their toxins in the blood or tissues. A disorder characterized by the presence of pathogenic microorganisms in the blood stream that cause a rapidly progressing systemic reaction that may lead to shock.