ED Coding and Reimbursement Alert

Question: A 42-year-old female is brought to the ED by ambulance after being rescued from a house fire. She has suffered burns to 60 percent total body surface area (TBSA), with 10 percent full-thickness and 50 percent partial-thickness burns, primarily on her hands, arms, legs, and feet with a few severe burns on her face and scalp. The emergency medical technicians started intravenous fluids in the ambulance and there is significant swelling. The patient also had severe smoke inhalation and is struggling to breathe. The ED physician spends 79 minutes stabilizing the patient and treating her burns. Escharotomies are needed on both legs due to swelling (two incisions per leg). The physician fully evaluates the patient; current concerns, other than the actual burns, are impending respiratory failure, possible carbon monoxide poisoning (labs are drawn), and tachycardia. Upper airway swelling causes the ED physician to order a tracheotomy, and the patient [...]