Alright, my turn, burn codes. Actually, I thought this was going to be a long one. It’s actually an easy one. So Theresa writes, “Here’s a question. What CPT in ICD 9 CM codes would be used to code a subsequent encounter in which a split thickness skin graft, both thighs to the abdomen measuring 45 by 21 cm is performed on a patient who has 3rd degree burns of the abdomen? Documentation stated 20% of the body surface was burned with 9% 3rd degree. The patient has also sustained 2nd degree burns of the upper back.” And then these are the correct answers given. So we got the 2 CPT codes and then we have 942.33 and 942.24 and then 948.20.
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Now 948 has to do with the percent of body area affected. What she’s asking is why are there 2 942 codes? I thought we were only supposed to code a 942 code one time combining the two areas. And she’s absolutely correct. So this is a practice question that clearly has a wrong answer. The coding guidelines, when you learn ICD coding guidelines, they’ll tell you, for multiple burns, how to handle them.
Let me see what I put on my answer sheet here. Oh, I just copied the guidelines for Chapter 17 – Injury and Poisoning. And it says, ‘The principle of multiple coding of injury should be followed whenever possible.’ So it probably is better to just go to Find A Code and let me go to 942.
So I tried to get my document camera to show you this one but I wouldn’t cooperate tonight so I’m using the encoder. So basically, 942 is a category code – burn of the trunk. Then our fourth digits have to do with the degree – 1st degree, 2nd degree, 3rd degree. It’s the 5th digits that have to do with further specificity of location.
So in this scenario, I think it said trunk… oh no, two areas of the trunk. I can’t remember right now, let me see here. So we got the abdomen and then they also had upper back. So those are both categorized to the trunk, to the category 942. But what they should actually be using is the 5th digit of… I’m trying to see this in context here. 942.09 – burn, multiple sites of trunk. Now we’re not necessarily going to pick the 4th digit of 0. We picked the worst burn. So in this case, I think it was a 3rd degree so we’d actually go to 942.39. The point is that you’re only going to have one 942 code on any given claim because you’re supposed to group them together and that’s why we have the 5th digit of 9 for multiple sites of the trunk. So that’s just an example of an answer key not giving the correct answer. So, good thinking it through.
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