How many codes from R65.2 can be assigned when a non-infectious condition leads to an infection resulting in severe sepsis?

When coding for cases where a non-infectious condition leads to an infection resulting in severe sepsis, the assignment involves the appropriate combination of codes to accurately reflect the patient's clinical picture. In this scenario, severe sepsis resulting from a non-infectious condition requires careful documentation.

The guidelines indicate that when a non-infectious condition results in severe sepsis, you typically assign one code for the underlying condition and one code for the severe sepsis itself. However, the specific inquiry about how many codes from R65.2 can be assigned may lead to confusion. R65.2 specifically identifies severe sepsis without the associated acute organ dysfunction.

In this case, you would report the code for the severe sepsis, and depending on the specifics of the situation, you would also document the underlying condition—this means one of the codes would relate to the sepsis while the other would correspond to the initial condition, making a total of at least two relevant codes (one related to severe sepsis and one for the underlying condition).

Therefore, choosing one code from R65.2 would be appropriate when documenting severe sepsis if you were only reporting the sepsis alone, but for a comprehensive capture of the patient's condition when merging into COVID