Medical Coding And Billing Tutorials for Beginners | ICD, CPT| ICD-Chapter19 (Part-3) - 8

Today we'll continue chapter 19 and this

is the last part of chapter 19. After

that we'll complete some question and

answers. Okay. So I start again with

quick review of reporting burns. Okay.

Can you tell me how to report burns?

It's okay. I'll tell you. We need at

least three codes to properly report

blood diagnosis. Uh sorry burn

diagnosis. And first step will be sight

and severity specific course from

category T20 to T25. Okay. First these

codes are codes of combination codes

that reports both sight and severity of

the injury or burn. Okay. And code

ranges is T20 to

T28 defined by anatomical location of

the body affected by burn or corrosion.

Okay. Then fifth, fourth character these

three characters and fourth character

identifies severity means uh percentage

okay or degree of burn first degree,

second degree, third degree except

category T26 to T28 which is for I and

internal organs which we not coded with

degree right that's why then fifth

character gives additional details

regarding anatomical sight of one and

sixth character is for laterality and

seventh character will be for initial

encounter, subsequent encounter and for

sequel. Okay. ADS. Yeah. ADS. Yeah. So

this is first step which is from T20 to

T25 category. Okay. T20 to T28. Then

second next listed code will be E for

extent. How to find out this code? I

asked you to note down that step.

percentage of H total body surface area

but but how will you get that first

degree second degree third degree no you

see no no this is extent okay go through

recordings yeah actually I'm reading now

the I'm I'm the chapter 9 only just two

hours ago I reading but I'm reading

about this why are you reading chapter n

you're not chapter 19 only type of

fractures I saw uh I39 chapter 19 only

type of factors I'm reading okay so I go

through this uh yesterday's slide but

day before yesterday's slide I'm reading

so okay but whenever I ask you to note

down some point please make note of it

so it will be okay so we have to go to

burn search for burn term in alphabetic

index and then this will be our first

course. Okay, first step course which is

according to anatomical sides. Okay,

clear. And after that we need this

second step. For this second step, next

listed code will be E for extend which

you will get from category T31 for burn

and T32 for corrosions. So to find out

this code we have to again we are in

burn category only in burn term. Okay.

Hello. Yeah. Yes. And under the burn we

have to search for extend remember.

Yeah. I remember I forgot yesterday that

so that in most of the cases this will

be our second code or additional code

you can say you know an burning burn

anatomical site when you completed after

that you have to code this use this code

extent of burn which gives you

percentage of total body surface area of

a TBSA plus uh percentage of Third

degree burn. Yeah. So it will be depend

on provider means whenever you start

your job it will be depend on your

client that whether he required that

client required more than 20% uh third

degree burn only or less than 20% is

also okay. So it will be depend on

client specification. But this will be

your step second step like this. Yes.

You can't see the slides. Oh, okay. Now,

yeah, now I can then see this one also,

right? Yeah. So, I'll explain again.

Sorry for that. So, the burns, we have

to go in the burn term and search for

our course which will be our first step.

Okay, this for this step T22, T25 or

T28. For first step, we need to code

from this depend on anatomical site and

degree. Open each and every side have

code different code for first degree,

second degree, third degree plus depend

on laterality also. Okay. And this is

first step. After that second step will

be this. We have to search for

extent. Okay.

And select code from this category under

which present under the extent C uh

extent term which gives you percentage

of total body surface affected. Okay.

plus third degree burns percentage of

third degree burn. So select your code

carefully. If 32 suppose 35% total body

surface area is affected in that case

you have to select this code. Okay you

have to go through uh 32 39%.

And then if among that 30 to 35% if

again 28% of third degree burns are

there in that case you have to select

under this 30 to 39% we have to select

this 20 to

29%. Third degree burn okay provider

tells about this yes percentage will be

given to you to calculate but you have

to remember this rule of nine. Okay.

Get question on this. That's right.

While you're going for interview or

either in your examination, you'll get

in question on this. What is rule of

nine? Or they will give you percentage

and ask you it is true or false

anything. Okay, that's why you need

percentage. 9% for head 99% for each arm

and front and back 18 18% and legs 18

18% and genitalia 1%. And this

percentage is change in case of infants

because infants has larger head than

younger one right that's why for infant

it is 18% for hair and

14% for other other percentages same so

this is our second step burn and

corrosions are classified according to

the extent or percentage of the body

total body surface area involved TBSA

And please remember this full forms also

you will get you may get straightforward

question on a code from category T31 is

used when site is not specified to

record burn mortality or when there is

mention of third degree burn involving

20%. or more body surface. Okay. When

you need to use this code E for extend

this second step code when if site is

not specified just they give you a total

body surface area involved. In that case

we have to use this code. Okay. Or else

if third degree burns are there to

represent that third degree burn

separately we have to add this code

also. In two these two cases you have to

use this code. Okay. So code T31 is for

burn and T32 is for corrosion based on

rule of classic rule of nine that just

we saw percentage the required fourth

character identifies percentage of

patient's entire body affected by burn

and fifth character identifies

percentage of patient's body suffering

from third degree burn or corrosions

only. Okay. So this is our second step.

Not each and every time this is required

but in most of the cases this is

required. If site is not specified just

percentage is given percentage of burn

is given and if third degree burns are

present. And third step will be e code

for external cause or agent if

corrosions are there if agent is given

you have to code that. And if external

cause is given source place or intent of

burn anything is given you have to use

those codes additionally. And again when

you came across question for related to

burn you have to read that question

carefully know what exactly they asking

for. If they asking just for external

cause sometime they give you each and

everything and lastly ask just only for

code external cause. Okay. And sometime

they ask only to code burn. So be

careful you are reading your question

carefully. This is how burn and

corrosion coding looks like. First code

for body side uh depth encounter and

laterality. Second code is for second I

can't say second because it may include

more than one code right because it

depends on body side and laterality and

degrees. So second step will be extend

to depend on total body surface area and

third degree burn and uh third step will

be external cause or agent clear it's

clear uh here why can't we mention the

stepwise it will be right what why can't

we mention the step wise first step is

the body set second is the extent if you