Primary Care Coding Alert

Start at 940.x and work your way up on burn ICD-9s.

When your FP performs burn treatment for a patient, you need to be ready to select code(s) from the 940.x-949.x ICD-9 group. Knowing which, and how many, of these codes to report will make the difference on your burn treatment claims.

Step 1: Select Anatomic Burn Dx

When coding for burns, first check if the FP included the location of the burn in the notes, advises Jeffrey F.Linzer Sr., MD, MICP, FAAP, FACEP, associate medical director of compliance and business affairs for the division of pediatric emergency medicine, Department of Pediatrics, at Childrens Healthcare of Atlanta at Egleston.

If you can discern the burn location, report a code from the 940.x-947.x code set.

This code represents the anatomic location and the degree/thickness of the burn, explains Cecilia Forde,CPC, CPC-H, coding specialist for Floridas Centra Care.

Example: Notes indicate that the FP treats a patient for first-degree burns to his abdominal wall and lower back. The proper diagnosis for this patient is 942.19 (Burn of trunk; erythema [first degree]; other and multiple sites of trunk).

Remember: When using a 940.x-947.x ICD-9 code,be sure to always code to the available number of digits: 940.x, 946.x, and 947.x code to a fourth digit; 941.xx-945.xx always code to a fifth digit, says Linzer.

Step 2: Use 948.xx on 3rd Degree Burns

Once you have settled on a code from the 940.x-947.x set to represent the location and degree of the burn, prepare to select a code from the 948.xx set as a secondary diagnosis if the patient has suffered any third-degree burns. In the 948.xx set, the fourth digit indicates the percent of total body surface area (TBSA) that suffered burns, while the fifth digit indicates the percent of TBSA with third-degree burns.

Example: The FP treats a patient for burns to 18 percent of his body; 7 percent of the burns are third-degree.The appropriate code to represent this injury is 948.10 (Burns classified according to extent of body surface involved; 10-19 percent of body surface; less than 10 percent or unspecified), which youd submit in addition to the code from 940.x-947.x, if possible.

Exception: There are situations in which a code from the 948.xx set might be the only diagnosis code on a burn claim, Linzer reminds. If the notes do not indicate the burn location but do specify the TBSA of the burn, report 948.xx only.

For example, if the physician documents burn covers 60 percent of BSA with half third-degree, you would report 948.63 (& 60-69 percent of body surface; 30-39%) as the only diagnosis, explains Linzer.

Step 3: Use 949 as a Last Resort

If documentation doesnt specify a burn location or the extent of body surface burned, you will have no choice but to report 949.x (Burn, unspecified) with the appropriate fourth digit to indicate the burns degree, says Linzer.