R65.11 Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction

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

Use additional code

• code to identify specific acute organ dysfunction, such as:
• acute kidney failure (N17.-)
• acute respiratory failure (J96.0-)
• critical illness myopathy (G72.81)
• critical illness polyneuropathy (G62.81)
• disseminated intravascular coagulopathy [DIC] (D65)
• encephalopathy (metabolic) (septic) (G93.41)
• hepatic failure (K72.0-)

Applies from R65.1 Systemic inflammatory response syndrome (SIRS) of non-infectious origin

Excludes1 (never code together)

• sepsis- code to infection
• severe sepsis (R65.2)

Code first

• underlying condition, such as:
• heatstroke (T67.0-)
• injury and trauma (S00-T88)

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) 864 in MDC 18.

Approximate ICD-9-CM (GEMs)

• 995.94 Systemic inflammatory response syndrome due to noninfectious process with acute organ dysfunction

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to R65.11

Back-references to R65.1

• Use Additional: T67.0 Heatstroke and sunstroke ("systemic inflammatory response syndrome (R65.1-)")

Diagnosis Index entries for R65.11

• Syndrome › systemic inflammatory response (SIRS), of non-infectious origin (without organ dysfunction) › with acute organ dysfunction
• System, systemic › inflammatory response syndrome (SIRS) of non-infectious origin (without organ dysfunction) › with acute organ dysfunction

Nearby codes

• R65 Symptoms and signs specifically associated with systemic inflammation and infection
• R65.1 Systemic inflammatory response syndrome (SIRS) of non-infectious origin
• R65.10 Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction
• R65.11 Systemic inflammatory response syndrome (SIRS) of non-infectious origin with acute organ dysfunction (this code)
• R65.2 Severe sepsis
• R65.20 Severe sepsis without septic shock
• R65.21 Severe sepsis with septic shock