Shock, septic

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	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

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

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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.
• Also recognize that not all vasodilatory (aka distributive) shock is due to infection. When it is due to infection then use THIS code, when it's not due to infection, then use one of the other appropriate codes, such as: Anaphylactic reaction (anaphylaxis), or Shock, NOS
• If you code this, then do NOT also code Severe sepsis

q Are we to switch now and use this definition for old dx coding (Septic Shock) as written and not our old definition which was more detailed?GHall 08:41, 2018 August 30 (CDT) AG REPLY --- totally OK to switch over now to the new defn and not wait until 1/1/19

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Alternate ICD10s to consider coding instead or in addition

• Anaphylactic reaction (anaphylaxis) -- includes anaphylactic shock

• Severe sepsis

• 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

Data Integrity Checks (automatic list)

	App	Status
Query s tmp QASeptic tmp no dx	CCMDB.accdb	implemented
Query s tmp QASeptic Dx no tmp ICD10	CCMDB.accdb	implemented
Query check ICD10 Inf Infection req Pathogen must have one	CCMDB.accdb	implemented
Query Check Inf Pathogens must have Infection requiring pathogen or Potential Infection	CCMDB.accdb	implemented

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Show all ICD10 Subcategories

ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue, Musculoskeletal/soft tissue neoplasm... further results