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Compare/A41.9 vs A48.3

A41.9 vs A48.3

A41.9 (Sepsis, unspecified organism) compared with A48.3 (Toxic shock syndrome), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

Yes, when both are documented. A41.9 carries an Excludes2 note covering A48.3: “toxic shock syndrome (A48.3)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

No — do not report together. A48.3 carries an Excludes1 note covering A41.9: “sepsis NOS (A41.9)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

A41.9Sepsis, unspecified organismA48.3Toxic shock syndrome
Billing statusBillableBillable
ClassificationA00-B99 — Certain Infectious and Parasitic Diseases (A00-B99)A00-B99 — Certain Infectious and Parasitic Diseases (A00-B99)
DefinitionSepsis, unspecified organism is a billable ICD-10-CM diagnosis code (A41.9).Toxic shock syndrome is a billable ICD-10-CM diagnosis code (A48.3).
Includes
Septicemia NOS
Use additional code
code to identify the organism (B95, B96)
Code first
, if applicable, postprocedural sepsis (T81.44-)
sepsis due to central venous catheter (T80.211-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources