Question: When coding for burn, how many diagnosis codes do I need to report? When is it appropriate to include a code from the 948.xx category?
New Jersey Subscriber
Answer: On claims with burn treatment codes, you should include at least two diagnosis codes.
The first code, which represents the location of the patient’s burn, should come from the 940.x-947.x series.
Example: If a patient has a first-degree burn on her third, fourth and fifth knuckles, the proper diagnosis code would be 944.13 (Burn of wrist[s] and hand[s]; erythema [first degree]; two or more digits, not including thumb).
The second diagnosis code you’ll need comes from the 948.xx series and represents the total body surface area (TBSA) and severity of the burn.
Remember: While some of the 947.x codes are only four digits, you must carry all 948.xx codes out to the fifth digit. Here’s what you need to know:
• Fourth digit -- Percent of the TBSA affected by the burn of any degree.
• Fifth digit -- Percent of the body surface area with third-degree burns.
Example: If a patient’s diagnosis is 948.11 (Burns classified according to extent of body surface involved; burn [any degree] involving 10-19 percent of body surface; 10-19 percent of body surface with third degree), the fourth digit indicates that 10 to 19 percent of TBSA was burned. The fifth digit indicates that between 10 and 19 percent of the TBSA contained third-degree burns.
