Wiki Extent of Burn Coding Question

[MsGarner69]

I've been trying to understand the guidelines regarding burn coding and I'm kind of making myself confused. Now guidelines state that code section 948 is to be used for extent of body surface pertaining to third degree burns, but what I don't understand is the use of code 948.0. So if I have third degree burns on both legs(hip to toe) and a second degree burn on my hand then would I code 948.11, 948.00? I think what's confusing me the most is when you have a degree (other than 3rd) and I'm assuming we would always use 948.0 sub category for those, along with whatever 3rd degree burn codes we need for extent of body surface as well.

 

[mitchellde]

the 948 codes are used only when you have 3rd degree burns. The 4th character is for the entire body amount burned and the 5th is for that percent which is 3rd degree.
so 948.11 would mean you have 10-19% body surface burned with 10-19% in 3rd degree. 948.21 is 20-29% body surface burned with 10-19% in 3rd degree.
So if you only have 2nd degree you do not code the 948 codes.

 

[MsGarner69]

So if you only have 2nd degree you do not code the 948 codes.

Hello Ms. Mitchell, thanks for responding. I was leaning toward that but then the code description for sub category 948.0 confused me because it states "Burn [any degree]..." so to get even a better understanding I was searching online for any thing that could help me then I ran into this scenario

Case Study: A 24 yr old young man presents with a third degree burn on the right forearm 2%; first degree burn on right wrist 3%; and second degree burn to the right chest wall 5%. He states that he got burned by hot steam while working in a restaurant.


Here?s how the Codes should be sequenced:
943.31 (3rd degree burn forearm);
942.22 (2nd degree burn chest wall);
944.17 ( 1st degree burn wrist);
948.11 (Percent TBSA ? indicates the percentage of body surface with 3rd degree burns);

now the 948.11 code confused me because the extent of body surface with 3rd degree burns was only 2% so I thought 948.00 should be used but they combined all the percentages together to come up with this code and I didn't understand why because it doesn't accurately reflect the percentage of his 3rd degree burn.



Then I read here(page 37)

http://www.mlcoleman.com/review/coding_burns_part1.pdf
that you can use code 948 for 1st and 2nd degree burns. and if you notice, on page 38 they combined the 1st, 2nd and 3rd degree totals to get 948.63 when I'm thinking it should be 948.33 since that accurately reflects the percentage of 3rd degree burns only. I think the "any degree" part is what's throwing me off track here.

 

[mitchellde]

the correct answer for the case study is 984.10 total body percent burned is 10% only 2% is 3rd degree.in the link you provided on pg 38 the total body percentage burned is 64% which is fourth digit 6 then 36% was 3rd degree which is 5th digit 3. I know she says to use it with 2nd and first degree but this is never done, it is used only with 3rd degree. The guidelines state:
It is also advisable to use category 948 as an additional code for reporting purposes when there is mention of a third-degree burn involving 20 percent or more of the body surface.

 

[MsGarner69]

the correct answer for the case study is 984.10 total body percent burned is 10% only 2% is 3rd degree.in the link you provided on pg 38 the total body percentage burned is 64% which is fourth digit 6 then 36% was 3rd degree which is 5th digit 3. I know she says to use it with 2nd and first degree but this is never done, it is used only with 3rd degree. The guidelines state:
It is also advisable to use category 948 as an additional code for reporting purposes when there is mention of a third-degree burn involving 20 percent or more of the body surface.

it's just really too much going on in this field of study lol Thanks for clarifying things Ms. Mitchell.