General Surgery Coding Alert

You'll still need additional TBSA code.

Reporting burns by body site/"degree" plus an additional code for total body surface area (TBSA) won't change when you start using ICD-10 in Oct. 2013. But reporting the cause of the burn will.

ICD-10 Distinguishes Burn Source

A burn is a burn for ICD-9, but a burn may be a corrosion in ICD-10. "Corrosions" are chemical burns, and the new diagnosis coding system will allow your surgeon to make a distinction.

Example: Let's say a patient has a second degree burn of the right thigh from accidentally spilling boiling water. Under ICD-9, you'd report the condition as 945.26 (Blisters with epidermal loss due to burn [second degree] of thigh [any part]). For ICD-10, you should list T24.211- (Burn of second degree of right thigh...).

Now let's say you have the exact scenario, except the burn is from an accidental spill of a strong acid. With ICD-9 you would still use 945.26. But for ICD-10, you'll use a different code -- T24.611- (Corrosion of second degree of right thigh...).

Notice right/left: You can see that ICD-10 lets you zero in on body site more specifically than ICD-9 does. ICD-10 providesdistinct codes for you to report bilateral body sites as right, left, or unspecified.

Capture 'Additional' Codes

Like ICD-9, you'll need to list a distinct ICD-10 code indicating the extent of burns (or corrosions) using a unique TBSA code.

For instance: Assume the prior two examples involved 11 percent of the patient's total body surface area with no third degree burns. In ICD-9, you'd report 948.10 (Burn [any degree] involving 10-19 percent of body surface with third degree burn of less than 10 percent or unspecified amount).

But for ICD-10, you'll have two TBSA choices based on the burn/corrosion distinction:

• T31.10 -- Burns involving 10-19% of body surface with 0% to 9% third degree burns
• T32.10 -- Corrosions involving 10-19% of body surface with 0% to 9% third degree corrosion.

Corrosions take more: Not only do you have distinct "corrosion" codes in ICD-10, you also need to report a uniquecode to identify the cause of the chemical burn. Preceding the corrosion codes, ICD-10 provides this instruction: Code first: (T51-T65) to identify chemical and intent.

In our prior example, you would report the acid burn to the thigh by reporting first T54.2x1- (Toxic effect of corrosive acids and acid-like substances, accidental [unintentional];-).