Broad expansion proposed for sepsis ICD-10-CM coding

At the public ICD-10 Coordination and Maintenance Committee Meeting held March 17–18, the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) is discussing a draft proposal involving a broad expansion of sepsis diagnosis coding.

NCHS previously attempted to revise ICD-10-CM sepsis coding in September 2019, but the changes were never finalized due to negative public feedback. Now, the agency is exploring options to expand the code set to include impending sepsis. Additionally, it is proposing to create codes to identify the organ dysfunction present, as well as delete the severe sepsis code and terminology, based on Sepsis-3 definitional changes.

The draft proposal illustrates how these changes would impact code A41.9, which is currently used to report sepsis, unspecified organism. In this example, the code would be revised and split into A41.91 (sepsis, unspecified organism) and A41.92 (impending sepsis, unspecified organism) for further specificity. NCHS also detailed how the updates to code A41.9 would result in new, revised, and deleted codes under category R65 (symptoms and signs specifically associated with systemic inflammation). This example is only one of approximately 40 sepsis codes that the agency anticipates that the proposal would apply to.

The public has until May 15 to submit comments on updates being considered for implementation on April 1, 2027. NCHS noted that this sepsis proposal is meant to elicit public comments ahead of the September 2026 public meeting, during which a more formal presentation is expected. With this in mind, these changes are not likely to be finalized until at least 2027.

Other diagnosis topics discussed in the meeting include biomarkers for Alzheimer’s disease, congenital hyperinsulinism, and more. A recording of the meeting is expected to be posted by the CDC once it concludes.