General Surgery Coding Alert

Question: A patient presented with multiple friction "burns" from a treadmill. He had partial thickness friction burns to one hand, both ankles, and one foot. He had a full thickness friction burn down to the fascia on two fingers. Our surgeon cleaned all burns with Shur-Clens® and debrided the loose skin, applied Silvadene®, and applied gauze and dressings to all burn areas. What codes should we report -- should we use burn codes?

Maine Subscriber

Answer: ICD-9 does not classify friction burns as "burns" -- rather, you should report them with a code from category 910-919 (Superficial injury). You should report the surgeon's service with an appropriate wound management code based on the documentation, such as 97602 (Removal of devitalized tissue from wound[s], non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion), including topical application[s], wound assessment and instruction[s] for ongoing care, per session).

4th digit classifies 'friction burns': ICD-9 categories 910-919 represent superficial injury to various body sites, each with a fourth digit for friction burns as follows:

• 0 -- Abrasion or friction burn without mention of infection
• 1 -- Abrasion or friction burn, infected.

On the other hand, ICD-9 classifies burns using a code from the range 940-947 (Burn...), depending on body site, plus a code from 948 (Burns classified according to extent of body surface involved).

Because local burn treatment codes 16000-+16036 rely on ICD-9 burn codes 940-949 to show medical necessity, you shouldn't use the burn treatment codes for the surgical treatment you describe. Instead, use wound treatment codes such as 97602 or 97605-97606 (Negative-pressure wound therapy ...).