If you are taking online medical billing and coding classes or considering enrolling into one, you can learn a lot by reading this post. Below is a scenario you may encounter often as a medical billing and coding professional.
Diagnosis: Male patient admitted for treatment of burns comprised of 1st, 2nd and 3rd degree burns of the chest, both arms, the abdomen and the front of both thighs comprising 46% of the patient’s body. 27% of the patient’s body is involved in 3rd degree 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 estimate the percentage of the body surface involved in burns. However, an extent of burn code is only assigned when the extent of body surface burned is documented by the provider. It is never a calculation made by a coding professional.
To create a valid code for the preceding diagnosis the first thing we need to do is determine the correct 4th digit. The patient had first, second and/or third degree burns of; the chest, both arms, the abdomen and the front of both thighs. The total of the percentage 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 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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