Shock, septic: Difference between revisions

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**Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection -- NOTE this was the 2001 definition of "severe sepsis"
**Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection -- NOTE this was the 2001 definition of "severe sepsis"
**Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
**Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
*'''CRITERIA for the SHOCK in Septic Shock''':  persisting hypotension requiring vasopressors to maintain MAP>65mmHg ''AND'' serum lactate>2 mmol/L -- both despite adequate volume resuscitation.
*'''CRITERIA for the SHOCK in Septic Shock''':   
*Septic shock is shock for which the CAUSE is proven infection OR '''presumed''' infection -- thus positive cultures are not required.
**Persisting hypotension requiring vasopressors to maintain MAP>65mmHg ''AND'' serum lactate>2 mmol/L -- both despite adequate volume resuscitation.
**The CAUSE is proven infection OR '''presumed''' infection -- thus positive cultures are not required.
**So, for example, if someone has another obvious cause of shock (e.g. massive hemorrhage) and ''also'' has infection, that does not mean it is combined hemorrhagic and septic shock. Basically, septic shock '''should not be called''' if there '''is another obvious cause for shock'''.
**So, for example, if someone has another obvious cause of shock (e.g. massive hemorrhage) and ''also'' has infection, that does not mean it is combined hemorrhagic and septic shock. Basically, septic shock '''should not be called''' if there '''is another obvious cause for shock'''.
*If you code this, then do NOT also code [[Severe sepsis]]
*If you code this, then do NOT also code [[Severe sepsis]]

Revision as of 07:36, 2018 May 9

ICD10 Diagnosis
Dx: Shock, septic
ICD10 code: R57.2
Pre-ICD10 counterpart: Septic Shock
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: 2019-0: Sepsis
Start Date:
Stop Date:
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

  • SMW
    • 2019-01-01
    • 2999-12-31
    • R57.2
  • Cargo


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  • SMW
  • Cargo


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Additional Info

  • Even though as of November 2017 ICD-10 has not yet been modified to reflect it, we are using the 2016 consensus definition of sepsis and septic shock (JAMA 315(8):801-10, 2016). These new definitions completely do away with talking about the Systemic Inflammatory Response Syndrome (SIRS). In the 2016 definitions we have just 2 subcategories:
    • Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection -- NOTE this was the 2001 definition of "severe sepsis"
    • Septic shock is a subset of sepsis in which profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
  • CRITERIA for the SHOCK in Septic Shock:
    • Persisting hypotension requiring vasopressors to maintain MAP>65mmHg AND serum lactate>2 mmol/L -- both despite adequate volume resuscitation.
    • The CAUSE is proven infection OR presumed infection -- thus positive cultures are not required.
    • So, for example, if someone has another obvious cause of shock (e.g. massive hemorrhage) and also has infection, that does not mean it is combined hemorrhagic and septic shock. Basically, septic shock should not be called if there is another obvious cause for shock.
  • If you code this, then do NOT also code Severe sepsis

Alternate ICD10s to consider coding instead or in addition

shock codes:
  • Bacteremia AND Fungemia, NOS -- these are laboratory manifestations, and while it's OK to code them if present, if you do so you should also code the clinical manifestation (such as sepsis, etc).

Candidate Combined ICD10 codes

  • Also code the causative infection.

Related CCI Codes

Related Articles

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