Wiki Sepsis-Cholecystitis

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Code: A41.9
Sepsis, unspecified organism
Septicemia NOS
Parent Code Notes: A41
Code first postprocedural sepsis (T81.4-)
sepsis during labor (O75.3)
sepsis following abortion, ectopic or molar pregnancy (O03-O07, O08.0)
sepsis following immunization (T88.0)
sepsis following infusion, transfusion or therapeutic injection (T80.2-)
Excludes1: bacteremia NOS (R78.81)
neonatal (P36.-)
puerperal sepsis (O85)
streptococcal sepsis (A40.-)
Excludes2: sepsis (due to) (in) actinomycotic (A42.7)
sepsis (due to) (in) anthrax (A22.7)
sepsis (due to) (in) candidal (B37.7)
sepsis (due to) (in) Erysipelothrix (A26.7)
sepsis (due to) (in) extraintestinal yersiniosis (A28.2)
sepsis (due to) (in) gonococcal (A54.86)
sepsis (due to) (in) herpesviral (B00.7)
sepsis (due to) (in) listerial (A32.7)
sepsis (due to) (in) melioidosis (A24.1)
sepsis (due to) (in) meningococcal (A39.2-A39.4)
sepsis (due to) (in) plague (A20.7)
sepsis (due to) (in) tularemia (A21.7)
toxic shock syndrome (A48.3)

Block Notes
Other bacterial diseases (A30-A49)

Coding Guidelines
Certain infectious and parasitic diseases (A00-B99)
Includes: diseases generally recognized as communicable or transmissible
Use additional code to identify resistance to antimicrobial drugs (Z16.-)
Excludes 1: certain localized infections - see body system-related chapters
Excludes 2: carrier or suspected carrier of infectious disease (Z22.-)
infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
infectious and parasitic diseases specific to the perinatal period (P35-P39)
influenza and other acute respiratory infections (J00-J22)


Cary, NC
Best answers
Can you please provide some direction on coding Sepsis due to cholecysitis. How many codes are necessary and the sequencing.


Cary, NC
Best answers

I wanted to provide the below information. If someone can take a look and tell me if they feel it is coded correctly

Sepsis with acute Cholecystitis:

Coding GUIDELINES (Page 7): (a) Sepsis For a diagnosis of sepsis, assign the appropriate code for the underlying systemic infection. If the type of infection or causal organism is not further specified, assign code A41.9, Sepsis, unspecified organism. A code from subcategory R65.2, Severe sepsis, should not be assigned unless severe sepsis or an associated acute organ dysfunction is documented.

(iii)Sepsis with organ dysfunction If a patient has sepsis and associated acute organ dysfunction or multiple organ dysfunction (MOD), follow the instructions for coding severe sepsis.

Coding GUIDELINES for Severe Sepsis (Page 7)

Severe sepsis The coding of severe sepsis requires a minimum of 2 codes: first a code for the underlying systemic infection, followed by a code from subcategory R65.2, Severe sepsis. If the causal organism is not documented, assign code A41.9, Sepsis, unspecified organism, for the infection. Additional code(s) for the associated acute organ dysfunction are also required

Sepsis with Acute Organ Dysfunction Coding

1. Follow the guidelines for severe sepsis
2. Severe sepsis requires at the minimum 2 codes (the acute organ dysfunction and R65.20 for the severe sepsis)
3. A41.9 should be coded as primary when there is no underlying systemic infection listed.

1. A41.9 (No underlying systemic infection noted)
Sepsis, unspecified organism
Septicemia NOS

2. K81.0: Acute Cholecystitis (Acute Organ dysfunction)

3. R65.20: Severe sepsis without septic shock Severe sepsis NOS