ICD-9-CM Diagnosis Coding: 948 Category of Codes for Burns

ICD-9-CM Diagnosis Coding | 948 Category Codes for Burns
One of the keys to reporting codes from the 948 category is to remember that the 4th digit reports the percentage of burns of all degrees (1st, 2nd and 3rd) from burn all sites and the 5th digit reports only the percentage of burns of the 3rd degree from all sites. (This means we will be counting the percentage of 3rd degree burns twice. Once in combination with 1st and 2nd degree burns and once all by itself)

The rule of nines is a tool to help us estimate the percentage of the body surface involved in burns if the documentation does not report a percentage provided by the physician.

To create a valid code for the preceding diagnosis the first thing we need to do is determine the correct 4th digit. We do this by estimating the percentage of body surface involved in all degree of burns. The patient had first, second and/or third degree burns of; the chest, both arms, the abdomen and the front of both thighs. Below is a breakdown of the estimate of extent of body surface involved for each site. (You may want to refer to the “Rule of Nines” chart found at category 948 in the Tabular List of your ICD-9-CM).

Chest = 9%

Arm = 9% per arm X 2 = 18%

Abdomen = 9%

Anterior thigh = 5% (approx) x 2 = 10%

(The anterior leg in its entirety equals 9%. The thigh is only the upper half of the anterior leg. Half of 9% is 4.5%. However, since the thigh is larger than the lower leg we add an additional .5% to account for the difference. Remember, this is an estimate, not an exact number but the estimate should make sense).

The total of the percentages of body surface involved in all degrees of burns is, 46%. When you check the code options for code category 948 the code with the 4th digit that reports burns of all degrees covering 46% of the total body surface is code, 948.4x; Burns classified according to extent of body surface involved, 40-49 percent of body surface.

In order to make a complete code we still need to assign the appropriate 5th digit based on the percentage of the body surface involved in 3rd degree burns only. The diagnosis indicates the patient had 3rd degree burns of the chest and both arms. If we refer to our rule of nines the percentages look like this.

Chest = 9%

Arm = 9% per arm X 2 = 18%

The total of the percentage of body surface involved in 3rd degree burns is 27%. When you check the 5th digit options for code category 948 the 5th digit that reports burns of 3rd degree involving 27% of the total body surface is “2”. The assignment of this digit completes our code and we would report code, 948.42; Burns classified according to extent of body surface involved, 40-49 percent of body surface, 20-29%.


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