Anesthesia Coding Alert

For burn codes such as +01953, a little TBSA knowledge helps you code.CPT provides three anesthesia codes for burn excision/debridement that are quite distinct from the anesthesia codes you're used to seeing on a day-to-day basis. Take the time to refresh your knowledge on these burn codes to ensure your setting is up to date.Take a Peek at Burn AnesthesiaThe three anesthesia codes for burn excision/debridement that CPT offers are:
 • 01951 -- Anesthesia for second- and third-degree burn excision or debridement   with or without skin grafting, any site, for total body surface area (TBSA) treated   during anesthesia and surgery; less than 4 percent total body surface area
 • 01952 -- . . . between 4 percent and 9 percent of total body surface area
 • +01953 -- . . . each additional 9 percent total body surface area or part thereof   (List separately in addition to code for primary procedure).Important note: You should use +01953 with 01952, according to CPT. You can't skip 01952 to get to the add-on code.Check Up on TBSA -- Here's How The attending physician should document the TBSA of the burn victim, often in collaboration with your anesthesiologist. "The surgical and anesthesia record should support each other," says Scott Groudine, MD, professor of anesthesiology for Albany Medical Center in Albany, N.Y. Usually, he adds, the surgeon will determine how large the burn is, but if your anesthesiologist disagrees, "we will come to an agreement because we can't have me billing for an 18 percent body burn and the surgeon claiming a 32 percent body burn."Generally, TBSA percentage determination is made using "The Rule of Nines." To help determine the extent of burn wounds, doctors have divided the body into 12 sections, front and rear, roughly representing 9 percent of the TBSA each. Exceptions are the genitals, which represent 1 percent, and the arms, which represent 4.5 percent on the anterior, and 4.5 percent on the posterior (whereas each leg is 9 percent on the anterior and 9 percent on the posterior). Knowing these "rules" may help you decipher reports when coding for your anesthesiologist.Watch for children: For infants and young children, the Rule of Nines is slightly different to allow for the larger surface of the child's head. Children's TBSA is 14 percent per leg, 18 percent for the torso, 18 percent for the back, 9 percent per arm, and 18 percent for the head.ICD-9 has some information on this "rule," under code 941 (Burn of face, head, and neck). It discusses degree of burns and includes an illustration for the Rule of Nines. Code 941 also provides fifth-digit subclassifications for burn wounds to the head.Use CPT: In the event the surgeon or burn specialist only notes the area being debrided, your [...]