Burn Medical Coding and the Rule of Nines https://www.cco.us/ceu-integumentary-system-on-demand-class-yt
A: You bet I can. And it is confusing because the terms are interchangeable, both of them use them and yet they do them for different reasons, and so it does. It gets a little confusing. This is actually a lot of slides but several of them are full page pictures.
What you need to know about burn coding for ICD, the questions that you need to know to get the proper code is: where is it, how severe is the burn, the percentage of body area, and the cause of the burn. Those are the things you need to know for ICD.
For CPT, you need to know the treatment status. In other words, “is this the first time they’re being seen” type thing, the degree of the burn and the type of treatment that’s being given.
Now, burns, for how severe they are, are going to be coded from 941-946, so you don’t have very many codes to choose from. This is going to be 1st, 2nd, 3rd degree. If you don’t know the difference, it’s real simple. First degree, it’s just red and painful. It’s like drinking a really hot cup of cocoa and you burn your tongue or scalding yourself in hot water.
Whereas, a 2nd degree burn is different, it’s quite painful and it’s red also but there are blisters involved. It actually went down into a lower level of the skin, which is another whole area that I chose not to talk about because there are lots of resources out there. A 3rd degree, that’s the most severe. That’s the one that causes all kinds of problems. It’s described as a full thickness skin loss and that means that it goes through all the layers of the skin. This can even go down into the bone and it’s really actually not painful as the others because it’s burned up the nerves, but the infection and the healing, it’s just a big hot mess.
If there are more than one burn present you always, always, always code first the most severe burn. So, if you got a 3rd degree burn on your pinkie and a 2nd degree burn on your elbow, the pinkie finger is going to go first because it’s a 3rd degree burn.
As we scroll down, I’ve got more information that we need to do and of course I always start with ICD because I enjoy ICD more.
Laureen: Someone is asking a question: Does a physician need to state the percentage of the body that is burned or can the coder use the rule of nines to determine the percentage?
Read more here:
https://www.cco.us/burn-medical-coding-and-the-rule-of-nines-video/