Anesthesia Coding Alert

Focus on area, then do the math.

In the March 2017 issue of Anesthesia Coding Alert (Vol. 19, N. 4), an example in the article “Think Like a Surgery Coder When Reporting Burn Care” was miscalculated. Anesthesia codes for burn care (such as 01952, Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area [TBSA] treated during anesthesia and surgery; between 4% and 9% of total body surface area) are calculated based on the total body surface area of burns treated, not the TBSA of burns.

The example was: A patient has third degree burns to 65 percent of his total body area. The operative report states that the surgeon debrided 1400 square cm of the chest and shoulders, but gives no other details. How do you calculate the correct percentage of burns to code?

Correct answer: Although 65 percent of the patient’s body is burned, the surgeon is currently treating the chest and shoulders. The treated area represents upper chest (approximately 9 percent) and shoulders (approximately 3 percent each), for an approximate total of 15 percent. The applicable anesthesia codes are based on the TBSA treated: for this case, 01952 and +01953 (… each additional 9% total body surface area or part thereof [List separately in addition to code for primary procedure]). Submit 01952 once for the first 9 percent, then 01953 x1for the remaining6 percent.