Pediatric Coding Alert

Pediatricians may not report sunburn care if they don't have the appropriate codes in front of them. Consequently, adding a few codes to your practice's fee ticket will alleviate the singe of lost revenue.

"Many pediatricians overlook using the burn codes because they are not included on their fee ticket," says Kay Faught, who has 13 years of experience in the coding field and is now a coding consultant in Jacksonville, Ore. Therefore, they code an office visit and give away the burn treatment. "That's why I always recommend including a burn-care section on physicians'superbills," she says.

Based on the practice's individual restrictions and frequency of treating sunburns, the added category may need to contain only four codes. For CPT Codes , Faught recommends that pediatricians include 16000 (Initial treatment, first-degree burn, when no more than local treatment is required) and 16020* (Dressings and/or debridement, initial or subsequent; without anesthesia, office or hospital, small) on their fee tickets. Putting the first- and second-degree burn codes in plain view will let the doctor know that these codes exist and to use them rather than an office visit code, such as 99212-99215 (Office or other outpatient visit for the evaluation and management of an established patient ), when appropriate.

Faught encourages practices to list diagnoses codes to ensure coding to the highest level of specificity. She suggests adding 692.71 (Sunburn) and 692.76 (Sunburn of second degree) to your superbill. Make sure to list 692.71 as "first-degree sunburn," she stresses. Many tickets contain a reference to "sunburn" only, which means you're not accurately coding to the fourth or fifth digit. Adding "first-degree sunburn" will let the pediatrician know that 692.71 includes first-degree only. In this case, if he treats a more severe burn and the diagnosis is not listed, he will know to include enough information in his documentation to guide you to a more accurate ICD-9 code.

Pediatricians clearly benefit by having a superbill as a tool to remind them of other coding scenarios. So, a burn-care section on a fee ticket may contain: