ED Coding and Reimbursement Alert

Question: I am having some trouble with burn diagnosis coding. When the patient has multiple burns, do I combine them and choose a diagnosis or code them separately?

Montana Subscriber

Answer: It depends on the anatomical location, or the severity of the burns -- or both. Without this information, it is difficult to choose accurate ICD-9 codes for multiple burn patients.

Check out this quick advice to solve this simmering problem on burn coding:

1. Code each burn separately if the burns occur in different locations, regardless of the burns' severity. Also remember to list the burn of the highest severity first on the claim. Let's say the patient has second-degree forearm burns and first-degree thigh burns on his right side. You'd report 943.21 (Burn of upper limb, except wrist and hand; blisters, epidermal loss [second degree]; forearm) for the forearm burn; and 945.16 (Burn of lower limb[s]; erythema [first degree]; thigh [any part]) for the thigh burn.

2. Group burns that share severity and location traits, then choose a single diagnosis code to represent the injury.

So if a patient has second-degree burns to his left calf, ankle, and toes, you'd report 945.29 (Burn of lower limb[s]; blisters, epidermal loss [second degree]; multiple sites of lower limb[s]) for all three burns.

3. Code separately for each burn when a patient suffers burns of varying degrees in the same anatomical location. So if a patient suffers from first- and seconddegree burns on her right shoulder, you'd report 943.25

(Burn of upper limb, except wrist and hand; blisters, epidermal loss [second degree]; shoulder) for the seconddegree burn; and 943.15 (... erythema [first degree]; shoulder) for the first-degree burn.