Each month, IBC will feature an example of how ICD-9 codes will translate to
ICD-10 codes. We will present coding examples from different specialties and
popular disease categories to demonstrate the granularity that the new ICD-10
code set will provide.
CODING CONVENTION: ICD-10 coding burns and corrosions
(continued from last month)
This article will convey the coding conventions used in assigning the
appropriate codes for burns and corrosions.
ICD-10 makes a distinction between burns and corrosions. In addition to the
distinction, there are coding conventions that are essential in attaining the
correct code assignment. These conventions include:
When more than one burn/corrosion is present, sequence the code that reflects
the highest degree first.
When the reason for the admission or encounter is for treatment of external
burns/corrosions, sequence the code that reflects the highest degree first.
When a patient has both internal and external burns/corrosions, the
circumstances of admission govern the selection of the principal diagnosis
(i.e., first-listed diagnosis).
When a patient is admitted for burn injuries and other related conditions such
as smoke inhalation and/or respiratory failure, the circumstances of admission
govern the selection of the principal diagnosis.
Burns/corrosions of the same local site
Classify burns of the same local site, but of different degrees, to the
subcategory identifying the highest degree recorded in the diagnosis.
Non-healing and infected burns/corrosions
Non-healing and necrosis (death) of burned skin should be coded as acute burns.
For any infected burn site, use an
additional code for the infection.
Assign separate codes for each burn site
When coding burns, assign separate codes for each burn site. Category T30,
?Burn and corrosion, body region
unspecified,? is extremely vague and should rarely be used.
Extent of body surface involved (categories T31, T32)
Burns and corrosions classified according to extent of body surface involved
should be assigned when the site of the burn is not specified or when there is
a need for additional data such as evaluating burn mortality (usually needed by
burn units), and when there is mention of a third-degree burn involving 20
percent or more of the body surface.
Categories T31 and T32 are based on the classic ?Rule of Nines? in estimating
body surface area that has been burned. The Rule of Nines is a system that is
based on the rough approximation that each arm has 9 percent of the body?s
total skin, the head and neck have 9 percent, each leg 18 percent (two 9s), the
front of the torso 18 percent, the back of the torso 18 percent, and the
genitalia 1 percent.*
*Providers may change these percentage assignments where necessary to
accommodate infants and children who have proportionately larger heads than
adults, and patients who have large buttocks, thighs, or abdomen that involve
Encounter for treatment of sequela of burns/corrosions
Encounters for the treatment of late effects of burns/corrosions (i.e., scars
or joint contractures) should be coded with a burn or corrosion code with the
7th character ?S? for sequela.
Sequela and current burn
Burns and corrosions do not heal at the same rate. A current healing wound may
still exist with sequela of a healed burn or corrosion. Therefore, when both a
current burn and sequela of an old burn exist, both a code for a current burn
or corrosion with the 7th character ?A? or ?D? and a burn or corrosion code
with ?S? may be assigned on the same record.
Use of external cause code with burns and corrosions
An external cause code should be used with burns and corrosions to identify the
source and intent of the burn, as well
as the place where it occurred.
Example: Burns of the same local site
Same local site
Secondary diagnosis code
Principal diagnosis code
For additional information related to the IBC transition to ICD-10, please
visit the ICD-10 section
of our website.
On this site you will also find other examples of how ICD-9 codes will
translate to ICD-10 codes in the ICD-10 Spotlight: Know the codes