Coding Alert: Welcome to Summer!  

The first day of summer will be this week, so it’s a good time for a look at some codes we may be assigning. Summertime brings more time outside relaxing and enjoying the warmer weather. Sunburn may be the result if we don’t keep applying that sunscreen.

Our sunburn codes are found at L55. We only have four straightforward code options here: L55.0 for Sunburn of first degree, L55.1, Sunburn of second degree, L55.2, Sunburn of third degree, and L55.9 Sunburn, unspecified. Cleveland Clinic notes that most first- and second-degree sunburns can be self-treated at home (I know I have on more than one occasion). The more-rare third-degree burn is severe and needs emergency treatment. So, when you are out this summer, remember your sunglasses, hat, and that sunscreen.

Heat stroke or sunstroke is a serious condition that occurs when your body gets overheated and can’t cool down. Cleveland Clinic notes that there are two types of heat stroke: classic, or non-exertional, and exertional. It goes on to detail that classic heat stroke occurs when the heat in your environment overwhelms your body’s ability to cool itself. This could happen in a hot car, in a house without air conditioning during a heat wave, or in outdoor heat. It is important to note that this classic type of heat stroke typically affects children and those over 65. In contrast, exertional heat stroke typically affects healthy young adults. This exertional type occurs with physical activity, usually in hot weather, but can occur in normal temperatures as well. In ICD-10-CM, we would find heatstroke and sunstroke at T67.0. Here we also have a use additional code(s) instructional note instructing us to identify any associated complications of heatstroke. Coma and stupor, rhabdomyolysis and systemic inflammatory response syndrome (SIRS) are listed as possible conditions. T67.01-Heatstroke and sunstroke includes heat apoplexy, heat pyrexia, siriasis, and thermoplegia. We also need to identify the encounter for treatment with seventh characters A for initial encounter, D for subsequent encounter, or S for sequela. T67.01XA, Heatstroke and sunstroke, initial encounter, is a complication or comorbidity (CC) condition. 

T67.02- and T67.09 assign for Exertional heatstroke and Other heatstroke and sunstroke, respectively.  Both codes require the seventh-character extensions A, D, or S, and both conditions are CCs when the seventh character A for that initial encounter is assigned. Other conditions in our T67 category include heat syncope, heat cramp, heat exhaustion, and heat fatigue. We also have code selections for other and unspecified effects of heat and light. We have a Coding Clinic from the Fourth Quarter of 2019 that gives guidance on coding exertional heat stroke, noting that it is the most severe form of exertional heat illness. The guidance also reinforces the use of an additional code note at T67.0, instructing the coder to assign those associated heatstroke complications.   

We don’t want to forget about our external cause codes here. As we know, we can be very specific on our place of occurrence. We can assign for amusement park, beach, campsite, golf course, lake, seashore, public park, and zoo, to name a few. So, wherever you go this summer, remember to bring your sunscreen, stay hydrated, and have fun! 

Programming note:

Listen live to the Coding Report today on Talk Ten Tuesday with Chuck Buck, 10 Eastern.