Oct. 8-14 is National Fire Prevention Week. The diagnosis codes for burns are found in Chapter 19 (Injury, Poisoning, and Certain Other Consequences of External Causes) of ICD-10-CM. The Index entry for burns includes the non-essential modifiers of electricity, flame, hot gas, liquid, or hot object; radiation; steam; and thermal. Another Index entry is corrosion, which includes the non-essential modifiers of injury: acid, caustic, chemical, lime, external, and internal. Both entries are organized by anatomic site and degree of burn. According to the Official Coding and Reporting Guidelines, burns of the eye and internal organs are classified by site, but not degree.
The sequencing of burns is by the highest degree when more than one burn is present. When internal and external burns are present, the sequencing will be based on the circumstances of admission. When the patient is admitted with burns and related conditions, such as smoke inhalation and/or respiratory failure, the circumstances of admission govern the selection of the principal diagnosis or first-listed diagnosis.
Burns of the same anatomic site and laterality are coded to the highest degree. Non-healing burns are coded as acute burns. An infected burn is coded as a burn with an additional code for the infection. When multiple burns are present, code each anatomic site separately. The code for multiple sites should only be used when the medical record documentation does not specify the individual sites.
Code the extent of the burn(s) using T31 (Burns classified according to the extent of body surface involved) or T32 (Corrosions classified according to the extent of body surface involved). The estimation of the involved body surface is based on the rule of 9s: head and neck – 9 percent, anterior or posterior trunk – 18 percent, anterior or posterior leg – 9 percent, each arm – 9 percent, and genitalia is 1 percent.
Next, the coder should assign diagnosis codes for external causes, which identify the source of the burn as well as the place where it occurred. Your state data commission may provide guidance regarding external cause code reporting. For example, I am from the state of Pennsylvania, and the Pennsylvania Health Care Cost Containment Council (PHC4) requires external cause codes on every encounter that a trauma code is reported. This requirement is different from the Official Coding and Reporting Guidelines, which directs providers to report the external cause code on the initial encounter. It is important to note the data reporting requirements for this topic.
The reporting of burns/corrosions is part of trauma reporting. This information is circulated beyond the adjudication of claims, so it is important to be accurate.
Be safe out there!
Resources:
ICD-10-CM, 2024
Official Coding and Reporting Guidelines, ICD-10-CM, 2024
Properly managed identity queues like roster management engines (RMEs) that mitigate errors and potential overlays lay the foundation for a well-maintained master person index (MPI)
The following topics have a place in your facility-specific coding guidelines: Personal History – Does the facility capture personal history codes? These codes may be
Please log in to your account to comment on this article.
Michelle Wieczorek explores challenges, strategies, and best practices to AI implementation and ongoing monitoring in the middle revenue cycle through real-world use cases. She addresses critical issues such as the validation of AI algorithms, the importance of human validation in machine learning, and the delineation of responsibilities between buyers and vendors.
Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.
Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.
Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.
Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.
HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2024 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s third quarter 2024 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’ is just $99 for a limited time! Use code WorldHealth24 at checkout.
