Part B Coding Coach: Don't Let Burn Coding Singe Your Reimbursement

Keep your burn coding cool with these 7 expert steps

Confused by the number of burn coding options? You're not alone.

With some diagnoses there is clearly one code series to choose from - but that's not the case with burns. ICD-9-CM lists codes for both burn location (940-947) and percentage of body burned (948). And unlike some simpler diagnoses, burn codes require fourth and fifth digits to specify the degree and exact location of a patient's burn.

Even though codes exist for both burn location and percentage of body burned, you don't necessarily have to "report codes from both the 940-947 and 948" series, says Linda Martien, CPC, CPC-H, coding consultant with National Healthcare Review Inc in Woodland Hills, CA. Follow these seven expert steps for success to ensure your burn coding doesn't end up burning you:

1. Review documentation for all burn-related information. To report the most specific code, you'll need to know the burn location, burn degree and the percentage of body surfaced burned (this percentage is especially important for third degree burns).

2. Determine burn location. You should use codes 940-947 "to code the burn by body location," says Lisa Center, CPC, quality coordinator with Freeman Health System in Joplin, MO. ICD-9-CM divides codes 940-947 by the following locations:

940 - Burn confined to eye and adnexa

941 - Burn of face, head, and neck

942 - Burn of trunk

943 - Burn of upper limb, except wrist and hand

944 - Burn of wrist(s) and hand(s)

945 - Burn of lower limb(s)

946 - Burns of multiple specified sites

947 - Burn of internal organs

Start your coding by choosing the appropriate code based on location. For example, if a patient has a burn on her hand, you know to begin your coding with the 944 series.

3. Select a fourth digit based on degree of burn. If you are reporting 941-946, make sure to select a fourth digit, Center says. Codes 941-946 each list six fourth-digit options to indicate the degree of the patient's burn:

0 - Unspecified degree

1 - Erythema [first degree]

2 - Blisters, epidermal loss [second]

3 - Full-thickness skin loss [third degree NOS]

4 - Deep necrosis of underly ing tissues [deep third degree] without mention of loss of a body part

5 - Deep necrosis of underlying tissues [deep third degree] with loss of a body part

Exception: Codes 940 and 947 [...]

- Published on 2004-09-25

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