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 |
This diagnosis is a part of ICD10 collection.
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.
- Septic shock is shock for which the CAUSE is proven (or presumed) infection.
- 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.
Alternate ICD10s to consider coding instead or in addition
- Shock, hypovolemic shock or hemorrhagic shock
- Shock, septic
- Shock, cardiogenic
- Shock, NOS -- includes neurogenic shock
- Anaphylatic reaction (anaphylaxis) -- includes anaphylactic shock
- Toxic shock syndrome
- Bacteremia, NOS 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.
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