Question

1. Discuss the coding and sequencing of the coding of burns thoroughly and give an example.

2. Explain thoroughly the coding of sepsis, severe sepsis and septic shock. Give an example

Answer 1

1) According to American burns association, a burn is tissue damage with partial or complete destruction of skin caused by heat, chemicals, electricity, sunlight, or nuclear radiation.

There are degrees of burns like first degree :which is the damage of the outer layer , Second degree burns: indicate blistering with damage extending beyond the epidermis partially into the layer beneath it which is the dermis , Third degree burns indicate full thickness tissue loss with damage or complete destruction of both the layers of the skin including hair follicles , oil glands , and sweat glands.

ICD 10 has burns coding using rule of nine.

First listed code. (S) for site and severity (categories T20- T25): this is mainly about site and severity of burns which is defined by an anatomical location of the body affected by burn or corrosion. Severity is identified using the layers of the skin , the severity of a burn is identified by degree.

Next code : E for extent ( categories T31/ 32) : the burns and corrosion are classified according to the extend , or percentage, of the body surface are involved (TBSA) . The rule of nine, for adult patients , assigns 1% of TBSA to the genitalia , and multiple of 9% to other body areas which is 9% head , 9% per arm, 18% per leg etc . For infants , to account for their relatively larger head 18% and smaller legs 14%

Last code (s) : E for external cause codes : External cause - to identify the source , place , and intent of the burn

Thus these are the details regarding the coding of the burns.