Outpatient Facility Coding Alert

Question: Our physician treated a two-year-old patient with a bad sunburn. How do we code this?

Georgia Subscriber

Answer: You have to dig through the documentation to see what type of burn the child had and what treatment your physician provided. Generally, most of the pediatric sunburn cases merit E/M codes.

Example: A seven-year-old boy complains of sunburn after floating in the pool for long hours while on vacation. The physician examines the child and thinks the burn is superficial and will naturally heal in a few days. She prescribes an aloe vera gel and advises the patient to avoid touching his face and to not go out in the sun. This would likely be low-level E/M code such as 99212 (Office or other outpatient visit for the evaluation and management of an established patient ...).as the physician didn’t render any treatment or spend much time counseling the patient.

If it is first-degree burn and there is swelling and mild blistering you will submit 16000 (Initial treatment, first degree burn, when no more than local treatment is required) for the encounter. Generally, for a first degree burn the physician would prescribe a soothing topical treatment and may apply bandages to the burned area.

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