A48.3 Toxic shock syndrome

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Excludes1 (never code together)

• endotoxic shock NOS (R57.8)
• sepsis NOS (A41.9)

Use additional code

• code to identify the organism (B95, B96)

Applies from A48 Other bacterial diseases, not elsewhere classified

Excludes1 (never code together)

• actinomycetoma (B47.1)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
• CMS-HCC V22: HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
• ESRD V24: HCC 2

MS-DRG index

Defines the logic of DRG(s) 867-869 in MDC 18.

Approximate ICD-9-CM (GEMs)

• 040.82 Toxic shock syndrome

Code annotations containing back-references to A48.3

Back-references to A48.3

• Type 2 Excludes: A41 Other sepsis ("toxic shock syndrome (A48.3)")
• Type 1 Excludes: R57 Shock, not elsewhere classified ("toxic shock syndrome (A48.3)")

Diagnosis Index entries for A48.3

• Shock › toxic, syndrome
• Syndrome › shock (traumatic) › toxic
• Syndrome › toxic shock
• Toxic (poisoning) › shock syndrome

Nearby codes

• A48 Other bacterial diseases, not elsewhere classified
• A48.0 Gas gangrene
• A48.1 Legionnaires' disease
• A48.2 Nonpneumonic Legionnaires' disease [Pontiac fever]
• A48.3 Toxic shock syndrome (this code)
• A48.4 Brazilian purpuric fever
• A48.5 Other specified botulism
• A48.51 Infant botulism
• A48.52 Wound botulism
• A48.8 Other specified bacterial diseases