Proper ICD-9 coding for burn patients can require several codes.
Dermatology coders who cannot choose the proper diagnosis codes for each burn treatment patient could end up costing their practices time and money.
How? Let's say your dermatologist provides local burn treatment for a patient (16000, Initial treatment, first degree burn, when no more than local treatment is required). If the claim contains an inaccurate burn diagnosis code, or no diagnosis code at all, the insurer could deny claims for burn treatment based on lack of medical necessity. Snuff out potential denials by following these four quick steps to picking the perfect burn diagnosis codes for each burn treatment encounter.
Step 1: Check Notes for Location of Burn
When choosing a burn diagnosis code, you first need to check the anatomic location of the burn, confirms Kevin Arnold, CPC, director of compliance for LYNX Medical Systems, based Washington. If you have notes indicating the anatomy of the burn, you'll first choose a burn diagnosis code from the 940.x (Burn confined to eye and adnexa …) to 947.x (Burn of internal organs …) code set.
The first three digits of the 940.x-947.x codes “refer to the general anatomic location of the burn. The fourth digit refers to the degree of the burn, with the fifth digit being the most specific anatomic location of the group," says Arnold. Not all of the codes in this diagnosis set have fifth-digit requirements, but you must code to the fifth digit if the code specifies it.
Example: The dermatologist treats a patient with first degree burns on his left foot. On the claim, you would report 945.12 (Burn of lower limb[s]; erythema [first degree]; foot) to represent the patient's condition.
If you have no evidence of burn location in the notes, choose a code from the 949.x code set instead, explains Jeffrey Linzer Sr., MD, FAAP, FACEP, Associate Medical Director for Compliance, Emergency Pediatric Group, Children's Healthcare of Atlanta at Egleston.
For example, operative notes indicate that a patient suffered second-degree burns, but there is no indication as to the anatomical location of the burn. For this claim, you would choose 949.2 (Burn, unspecified; blisters, epidermal loss [second degree]) as a diagnosis code.
Step 2: Ensure You've Coded for All Burns
You'll also need to make sure that you are coding for each burn the patient suffered. How many codes you include to represent the patient's injuries depends on encounter specifics.
Article Source :- http://www.supercoder.com/coding-newsletters/my-emergency-medicine-coding-alert/diagnosis-coding-follow-these-4-steps-to-master-940-949-burn-diagnoses-article
Dermatology coders who cannot choose the proper diagnosis codes for each burn treatment patient could end up costing their practices time and money.
How? Let's say your dermatologist provides local burn treatment for a patient (16000, Initial treatment, first degree burn, when no more than local treatment is required). If the claim contains an inaccurate burn diagnosis code, or no diagnosis code at all, the insurer could deny claims for burn treatment based on lack of medical necessity. Snuff out potential denials by following these four quick steps to picking the perfect burn diagnosis codes for each burn treatment encounter.
Step 1: Check Notes for Location of Burn
When choosing a burn diagnosis code, you first need to check the anatomic location of the burn, confirms Kevin Arnold, CPC, director of compliance for LYNX Medical Systems, based Washington. If you have notes indicating the anatomy of the burn, you'll first choose a burn diagnosis code from the 940.x (Burn confined to eye and adnexa …) to 947.x (Burn of internal organs …) code set.
The first three digits of the 940.x-947.x codes “refer to the general anatomic location of the burn. The fourth digit refers to the degree of the burn, with the fifth digit being the most specific anatomic location of the group," says Arnold. Not all of the codes in this diagnosis set have fifth-digit requirements, but you must code to the fifth digit if the code specifies it.
Example: The dermatologist treats a patient with first degree burns on his left foot. On the claim, you would report 945.12 (Burn of lower limb[s]; erythema [first degree]; foot) to represent the patient's condition.
If you have no evidence of burn location in the notes, choose a code from the 949.x code set instead, explains Jeffrey Linzer Sr., MD, FAAP, FACEP, Associate Medical Director for Compliance, Emergency Pediatric Group, Children's Healthcare of Atlanta at Egleston.
For example, operative notes indicate that a patient suffered second-degree burns, but there is no indication as to the anatomical location of the burn. For this claim, you would choose 949.2 (Burn, unspecified; blisters, epidermal loss [second degree]) as a diagnosis code.
Step 2: Ensure You've Coded for All Burns
You'll also need to make sure that you are coding for each burn the patient suffered. How many codes you include to represent the patient's injuries depends on encounter specifics.
Article Source :- http://www.supercoder.com/coding-newsletters/my-emergency-medicine-coding-alert/diagnosis-coding-follow-these-4-steps-to-master-940-949-burn-diagnoses-article
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