Wednesday, April 27, 2011

Internal Medicine Coding: Friction Burns Are Still Considered Burns


In a particular scenario, a patient presented with multiple friction burns from a treadmill. He had partial thickness friction burns on one hand, both ankles, and one foot. He had a full thickness friction burn to down to the fascia on two of his fingers. The internist cleaned all burns with surclens and debrided the loose skin, applied silvadene, and used gauze and dressings to all burn areas.

Here you will need to calculate the total body surface area (TBSA) affected by the burns (based on the documentation) to code properly. The two possibilities for for the partial thickness burns are 16020 (Dressings and/or debridement of partial-thickness burns, initial or subsequent; small [less than 5 percent total body surface area]) or 16025 (… medium {example whole face or whole extremity, or five percent to 10 percent total body surface area]).


Often full-thickness burns require skin grafting. If that is the situation with this patient, the intern will refer the patient to a surgeon for definitive treatment. In the meantime, he might complete temporary debridement and dressing, however 16020 and 16025 include that care. If the burns weren't serious enough to call for grafting, however, include the burns to the fingers in your calculations with 16020 or 16025.

Here's what you need to do: When the patient returns for a check-up, you will turn to the same group of codes. Remember that the specific codes might change owing to TBSA, depending on how much healing has occurred. These codes have a zero day global period associated with them, allowing for repeat billing of the services for follow-up visits.