Wiki Burn TBSA calculation

[jliving77]

When calculating the TBSA for burns I'm looking at the picture of the rules of 9 in the ICD-9 book. I have a pt with 2nd degree burns of the neck, ear, chest and shoulder. My dr documented that using 'palm of hand protocal' she came up with 8-10% TBSA. I have never heard of this protocal. If I look at the picture I see 9% for head and neck, 9% for arm and 9% for chest. This would give me 27% which doesn't seem right because not the whole area of any part is burned. Would I just use the 8-10% the dr stated?
Jennifer CPC

 

[mitchellde]

Palm of hand is used for children the rule of nines is used for adults. Palm of hand for children is 3% approx of their body surface, this is not true nor accurate for adults. The 9 percent is for when the entire surface is burned, if less than say the whole arm is involved you would not have 9 percent surface involvement. Also for only second degree and lower we usually do not append the percent burned code.

 

[jliving77]

Thank you Debra. I thought that I had to code the TBSA if any second degree or higher burns were documented.

 

[mitchellde]

It is only required when you have 20% or more that is 3rd degree.