ED Coding and Reimbursement Alert

Don't let burn coding beat you; follow these steps for an easy path to reporting When a patient presents to the emergency department with a burn, things can get heated for the coder right away, mainly because the first step is so difficult to report.
 
Burn diagnosis coding, which the physician must perform before reporting any other service, can include multiple five-digit codes. Documentation must reflect severity and burn location, and there is a good chance a patient may have more than one burn area to report.
 
It's a lot to consider, but don't let the process turn you into a basket case. Follow these three steps to turn burn diagnosis coding into a cool breeze for your ED. Step 1: Code for the Burn Location Before you do anything else in burn diagnosis coding, you must select a code from the 940-947 ICD-9 group to explain the anatomic location of the injury. Codes from this group are always at least four digits, and often five for specificity's sake. In burn cases, two or more different codes could be reported from the 940-947 group for a single patient.   
 
"The first code is for the injured part of the body, the part that's been burned: the foot, the head, the chest, etc.," says Patricia Sylvia, RN, CPC, of Outer Banks Emergency Physicians in Nags Head, N.C. "These ICD-9 codes are for different (anatomic) areas."
 
Check the physician's notes to find where on the body the burn occurred, then select the appropriate ICD-9 code from the 940-947 series. There are eight different burn areas on the body, and each has an entry (see pages 270-272 in ICD-9 2004 for the complete list).
 
"When coding for burns, make sure that you use separate codes for each burn site on the body," says Joan Gilhooly, CPC, CHCC, President of Medical Business Resources LLC, in Deer Park, Ill. This means that multiple diagnosis codes are allowable when you report the condition of one burn patient, so don't be afraid to use more than one code from the 940-947 series if the situation calls for it. For example, if a patient presents to the emergency department with burns on her right thigh, right foot, and the right side of her trunk, you would report a code from the 942.xx series (Burn of trunk) and a code from the 945.xx series (Burn of lower limb[s]) to account for the entirety of the burn area.
 
These diagnosis codes don't include all types of burns, however, and you need to make sure that the burn you are reporting is indeed part of the 940-947 code group.
 
"These codes (940-947) don't include friction burn and sunburn. Those need to be excluded right off the bat" [...]