Dermatology Coding Alert

Question: Our dermatologist treats burn victims, and I'm wondering about diagnosis coding in these cases. Do I need to include a code from category 948 on every claim?

Michigan Subscriber

Answer: Yes. Once you locate code(s) to represent the patient's burn(s), find the appropriate code from category 948 (Burns classified according to extent of body surface involved) as a secondary diagnosis. The 948.xx codes can also serve as primary diagnoses when the documentation doesn't specify the burn site, according to ICD-9 2010.

Reason: This code helps paint a better picture of the patient's injuries: The fourth digit in the 948.xx code represents the total body surface area (TBSA) burned, and the last character indicates how much of the TBSA suffered third-degree burns.

Example: Let's say a patient has a severely burned right leg. The patient has multiple second-degree burns on the front of his right leg and additional third-degree burns to the back of his right leg, but no loss of body part. In this instance, you would list the following diagnosis codes in this order:

• 945.39 (Burn of lower limb[s]; full-thickness skin loss [third-degree NOS]; multiple sites of lower limb[s]) to describe the patient's third-degree burn
• 945.29 (... blisters, epidermal loss [second degree];multiple sites of lower limb[s]) to describe the second-degree burn
• 948.10 (...10-19 percent of body surface with third degree burn of less than 10 percent or unspecified amount) to represent the TBSA burned and the percentage of third-degree burns present.