DX Category Codes 946 vs. 949 – Video

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Alicia: This was a really interesting question. This came in from Chaim who absolutely is one of our PBC students at present time. He comes in to the Thursday night student webinar calls that we have for our PBC students, our Blitz students, and our Practicode students. It’s not anything like this webinar, it’s very casual and they get to talk back and forth with me.

Q: Diagnosis category codes 946 and 949 – what’s the difference? Can you give an example? Thanks, Chaim

A: Here’s an example: 946 burns at multiple specified sites. That is specific – specified sites. Here is the guideline where you can find this: When coding burns, assign separate codes for each burn site. Category 946 should only be used if the location of the burns are not documented.

You’re thinking, “When would they ever not document burns?” Well, surprisingly it can happen and I came up with an example off the top of my pretty little head, although my grandmother used to say “pointed head,” I like “pretty little head” better.

DX Category Codes 946 vs 949 – Video

Example: Patient arrived via ambulance with burns to the arms, legs and torso. Degree of burns range from 1st to 3rd degree. Patient was stabilized and life flighted to University Hospital and their burn unit. Perfect example; they didn’t have time to go into specific details, they got him stabilized and boom, he’s out.

What’s the difference between 946 and 949? Burn unspecified.

Again, here is the guideline which is the same place where you’d get the information: When coding burns, assign separate codes for each burn site. Category 949 Burns of specified sites should only be used if the location of the burns are not documented. Category 949, Burn, unspecified is extremely vague and should rarely be used.

In other words, you can probably find a better code, if you have better documentation, but I thought why not we’ll go with the same scenario?

Example: Patient was picked up at the scene of a motor vehicle fire and brought to a facility for stabilization and pre-treatment of burns to 90% of patient’s body via various degrees. IV lines established and patient transferred via Life Flight to University Hospital burn unit.

That actually happens a lot. Not for burns per say but the chopper goes out and they pick somebody up on the scene and their estimated time of arrival could be 15 minutes to the University Hospital – that’s an hour drive away. And they get ready to go up and the patient is not stable enough and so they have to set down at the closest facility, the closest hospital, make sure they’re stabilized. If the person was burnt like this, they might have trouble starting IVs because they can’t find the veins or the veins might not be there anymore. A lot of times they’ll go in and do a subclavian and hit the major artery, the subclavian vein, and put in multiple just like little fingers sticking out where they can put multiple IVs in at one time. But that is a procedure and it can’t be done per se in the helicopter but it’s going to give this guy a better chance of survival, so they’ll set down, take him out, do the procedure and then just go. And they call them “load and goes.”

Again, are you going to see this? Probably not. But if you do, there is a code for it. Do you want to use this code? No, you don’t want to use that code. Most likely you won’t have to, but again, we have a situation where something’s going very quickly, there is a possibility of that.

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READ THIS LATER! DOWNLOAD THE PDF >> CLICK HERE <<
2016-11-20T23:37:33+00:00

About the Author:

AliciaScott-Instructor
Alicia has been working in the medical field for over 20 years. She first learned about medical coding while working in a medical records department at a resort town hospital near where she was raised. Through the years she has held several jobs in the medical field from, CNA, EMT, Pharmacy technician and Medial Records Abstractor and Analyst. Outside of the medical field she has worked as a Real Estate agent, and owned her own on-line retail business. The medical field has always been where she felt the most comfortable. Alicia has taught medical coding, billing and medical law and ethics at a private college. She also did contract work in HCC Risk Adjustment and discovered she really enjoyed ICD work. Because she loves to learn Alicia is working towards her Masters in Health Care Administration with an emphasis on education. Having taken many online classes through the years to complete her degree she feels very comfortable with both face to face and on-line learning. Alicia will tell you that not only does she love medical coding but she has a passion for teaching it. Alicia lives in the middle of Texas with her husband who is a Pastor, five of her six children, three dogs and two cats.

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