ICD-10-CM Chapter 19 | Burns and Corrosions Coding Guidelines Explained

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so I'm ready to move on to some Burns

yeah let's talk

now we've got some burn ftrs burn

fraction facts to remember and what are

they well there are some definitions

first you need to know that a burn

includes thermal Burns

and these are burns from heat Source

such as fire electricity or radiation

and in this chapter you're also coding

for corrosions and corrosions or Burns

acquired through chemicals or contact

with chemicals

now sunburns are not coated in this

chapter sunburns are coated in the skin

chapter right they're coded in chapter

what is skin is it 12 I'm not sure

but not here not here

and also too we're going to review some

guidelines but I want to let you know

that you are free to go ahead and tap in

your tabular list so this is a guideline

that we're going to review here but feel

free I love this section because you've

got images of the degree of burns we're

going to talk about first degree second

degree and third degree burns but here's

a reference right

yeah so the first image is normal skin

the second represents first degree and

it's just pretty much

um the epidermis is burned so it's

superficial this burn is superficial and

often doesn't need

treatment emergent treatment but

sometimes they do depending upon where

you get burned also second degree burns

involve the epidermis and the dermis

right yeah and you can see the the

picture shows that there's some redness

swelling and also

the skin

looks like it has trauma to it

yeah now when we get to the third degree

burn

that's pretty bad so it's going all the

way down through the subcutaneous it

could even get to the Bone so that's

pretty extensive so when you think about

it

you will be coding these Burns according

to the severity so the third degree burn

will take precedence or be sequenced

before the second and the second before

first

just thought I would tell you

now let's get into the guidelines

all right so here is a clipping from

your MCG manual guideline

c19.d1 and this and these guidelines are

in order so you know you shouldn't be

asking what page is

c19.d1 you can just go ahead and just go

in order you know you're in chapter 19

just go in order and even if you have an

old MCG you still should be able to find

the guideline that way

now this is how you code and sequence

Burns number one you're going to code

them according to the location on the

body

number two the severity or the degree of

the burn you're going to code the more

severe first and of course that's the

third then the second then the first

degree

also you will code the extent or the

external cause of the body surface area

or the total body surface area it's

called ebsa or tbsa previously it was

called tbsa and a lot of players in

medical coding still call it tbsa but in

your book it's going to say ebsa

and then you're going to code the agent

or external cost code and it gives you

more in-depth description of how that

burn occurred and where it occurred

all right let me see is there anything

else

yep

sequencing make sure you sequence the

more severe first and also if there are

multiple Burns of different degrees

you're going to sequence the highest

degree first but if you have multiple

Burns in the same area multiple degree

burns in the same area you're only going

to sequence or code that highest degree

okay

all right

and don't forget this is guideline c19

Point d

and I just got ahead of myself

if you have multiple burns with this in

the same anatomic site

c19 Point D2

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and you're going to code only the most

severe so multiple burns on the same

anatomic site and they're different

degrees only code the most severe degree

and one more thing I want to talk to you

about

I want to talk to you about the rule of

nines

the rule of nines is what they call the

percentages

your body percentages right and these

are significant when you're coding for

the ebsa and the tbsa

right

so you don't have to remember this

because you can just write this down and

also some of your

icd-10-cms have the

um the rule of nines documented so

you'll see an image with the rule of

nines but generally this is what it is

this um part of your body and you know I

want to see what you can see so I'm

going to just take a moment to see

something

I want to see if you can see my you who

can see if you can see my pointer let me

know

talk in the chat when I scroll my point

around like this

oh yeah so you can see it awesome all

right so this part of the body thank you

so much this part of the body is your

trunk right and if you burn the entire

front of your trunk

that's 18

and I know it looks like the man is

backwards but

he is backwards right so if you burn the

back of his of the trunk that's 18 if

you burn the front the entire

um front of your trunk that's 18 of your

body

if you burn your entire arm

that's nine percent of your body the

other arm nine percent your entire leg

is 18 percent

entire leg 18 percent

in the genitalia one percent

and the head and neck

are nine percent

all right and sometimes you're going to

see drawings that you know carve out

carve them out differently you know they

may say you might see

um nine percent for the upper leg nine

percent for the lower you know nine

percent for the whole leg excuse me

three upper three lower I don't know but

they'll have their own little numbers

but

nine percent for the whole leg

the whole back leg nine percent of the

other so it's not going to be that like

that for the exam you're not going to

have to calculate things often they'll

give you the body area thank goodness

but if anyone says what are the rule of

nines you can give them this this is

easy

all right

I think that's what we need let's get

started we have some coding to do

and if you remember this is how we solve

scenarios moving forward and I'm talking

about after this class all right

highlight

eliminate

and determine your first listed and or

not and first listed or your principal

diagnosis

all right so you have two minutes to