The ICD-10-CM makes a distinction between burns and corrosions. The burn codes are for thermal burns, except sunburns, that come from a heat source, such as a fire or hot appliance. You also report e burn codes when electricity or radiation caused the burn.
Corrosions are burns due to chemicals. The guidelines are the same for burns and corrosions.
Current burns (T20-T25) are classified by depth, extent ,and agent (X code). Burns are classified by depth as first degree (erythema), second degree (blistering), and third degree (full-thickness involvement). Burns of the eye and internal organs (T26-T28) are classified by site, but not by degree.
Coders also need to append the appropriate seventh character to specify the encounter when coding for burns and corrosions:
- A, initial encounter
- D, subsequent encounter
- S, sequel
Be sure to check for code first and code additional notes. For example, a note under the code series T21.0 (burn of unspecified degree of trunk) instructs coders to use additional external cause code to identify the source, place and intent of the burn (X00-X19, X75-X77, X96-X98, Y92).
For T20.5 (corrosion of first degree of head, face, and neck), the note specifies: Code first (T51-T65) to identify chemical and intent.
If a patient suffers multiple burns, code the most severe burn first. For example, a patient comes in for initial treatment for third degree burns of the neck and first degree burns of the upper left arm. You would report:
- T20.37XA, burn of third degree of neck
- T22.132A, burn of first degree of left upper arm
Don’t forget to use additional external cause code to identify the source, place, and intent of the burn (X00-X19, X75-X77, X96-X98, Y92).
When a patient has both internal and external burns, you will select the principal diagnosis or first-listed diagnosis based on the circumstances of admission.
When a patient is admitted for burn injuries and other related conditions such as smoke inhalation and/or respiratory failure, select the principal diagnosis or first-listed diagnosis based on the circumstances of admission.