Example 1: Medical Terminology
a. T20.20XA, T20.30XA, T22.259A, T22.219A, T24.319A, T31.42, X03.0XXA b. T20.30XA, T24.319A, T22.299A, T31.42, X03.0XXA c. T20.09XA, T22.099A, T24.099A, T31.64, X03.0XXA d. T20.30XA, T22.299A, T24.319A, T31.64, X03.0XXA
Burn codes always have at least three codes: A burn code, a total body surface area code, or T31 category code, and an external cause code. Burn codes have the following rules, which can be found at the beginning of the ICD-10-CM manual under Guideline I.C.19.d Coding of burns and corrosions. Always code one location to the highest degree. For example, for first and second degree burns on the arm, you would only code second degree. When sequencing burn codes, always list the highest degree burn code first and end with the lowest degree burn code. For example, regarding first degree burns to the face and third degree burns to the arm, you would list the arm burn first and then the face burn. For question 33, answer B is correct because its codes describe the highest degree burn to each location and the burn codes are also arranged the in the correct order of highest to lowest degree of burn. To find the codes for the actual burns, we start with the areas with the third degree burns, in this case the face and thigh burns. Look up Burn/ face, and you will find Burn/ head. Burn, head, third degree is T20.30-. Search for Burn, thigh, third degree and you will find T24.319-9-. The second degree burns are for the upper and forearms. In the index, Burn, arm points to Burn, upper, limb. Looking up Burn, upper limb, multiple sites to code for both the upper arm and forearm, you will find that second degree is T22.299-. All of these need seven characters, with the seventh character being A, for initial encounter. The T31.42 (TBSA code) has the correct calculation when using the rule of nine (fourth digit burned to any degree; 9 x 5 = 45; five areas burned are head, arm1, arm2, leg1, leg 2; 5th digit describes only 3rd degree burns which are head (9), leg1 (9), and leg2 (9). 9x3=27). To find the code using the index, look up Burn, extent 40-49 percent with 20-29 percent third degree burns which points to T31.42. The external cause code correctly describes the bonfire incident. In the External Causes Index, look up Exposure, fire, not in building or structure which designates code X03.0. This also requires a seventh character of A, making the code X03.0XXA. Verify all codes in the Tabular.
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