From the coding guidelines:
Sepsis generally refers to SIRS due to infection.
Severe sepsis generally refers to sepsis with associated acute organ dysfunction.
Sepsis/SIRS with Localized Infection
If the reason for admission is both sepsis, severe sepsis, or SIRS and a localized infection, such as pneumonia or cellulitis, a code for the systemic infection (038.xx, 112.5, etc) should be assigned first, then code 995.91 or 995.92, followed by the code for the localized infection. If the patient is admitted with a localized infection, such as pneumonia, and sepsis/SIRS doesn’t develop until after admission, see guideline I.C.1.b.2.b)
This just an excerpt from the guidelines they cover this topic very well so I would encourage you to read this section.
but you cannot have an organ dsyfunction and no organ dysfunction together so you need to defer your sepsis code to the 995.91 for the organ dysfunction.
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