Anesthesia Coding Alert

Question: What are our coding options for a second and third degree burn excision?

New Jersey Subscriber

Answer: Coding for anesthesia during burn excision or debridement differs from other situations because you don’t simply choose a code based on the anatomic location. Instead, you focus on the extent of burn injury (or total body surface area, TBSA), which means you might need to brush up on some math skills.

CPT® provides three anesthesia codes for burn excision/debridement that differ from the anesthesia codes you’re used to seeing on a day-to-day basis:

• 01951 – 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; less than 4% total body surface area between 4 percent and 9 percent of total body surface area
• 01952 – … between 4% and 9% of total body surface area
• +01953 – … each additional 9% total body surface area or part thereof (List separately in addition to code for primary procedure).

Warning: Because +01953 is an add-on code, payers will not reimburse you if you report it without the appropriate primary code: 01952.

Here’s how to calculate: The attending physician should document the TBSA of the burn victim, often in collaboration with your anesthesiologist. The physicians need to agree on the amount of affected area so their claims will be consistent. For example, the anesthesiologist shouldn’t bill for an 18 percent body burn when the surgeon claims a 32 percent body burn. CPT® and ICD-10 both include information on “The Rule of Nines,” or the system physicians use to determine the extent of burn wounds. The CPT® illustration appears with burn treatment codes 16000-16030.