Lecture on Burns and Coding Guidelines

Jul 13, 2024

Lecture on Burns and Coding Guidelines

Overview

  • Focus on proper documentation and coding for burns
  • Emphasis on coding guidelines, sequence, and important categorizations

Types of Burns

  • Thermal Burns: From heat sources like fire, electricity, radiation
  • Corrosions: Burns from chemicals or contact with chemicals
  • Sunburns: Not included in this chapter, coded in the skin chapter

Burn Degrees

  1. First Degree Burns:
    • Affects epidermis only
    • Often don’t require emergent treatment
  2. Second Degree Burns:
    • Affects epidermis and dermis
    • Present with redness, swelling, and trauma
  3. Third Degree Burns:
    • Affects epidermis, dermis, and may extend to subcutaneous tissue and bone
    • Most severe, taking precedence in coding

Coding Burns

  • Guidelines from MCG manual, specifically guideline c19.d1
  • Step-by-Step Coding:
    1. Location: Code based on burn location on body
    2. Severity: Code more severe burns first (third degree > second degree > first degree)
    3. Extent: Code total body surface area affected (ebsa/tbsa)
    4. External Cause: Code the agent or external cause leading to burn

Special Cases and Sequencing

  • Multiple Burns: Sequence highest degree first
  • Same Anatomical Site: Code only the most severe degree if multiple degrees are present

Rule of Nines

  • Tool to calculate percentage of body surface affected by burns
  • Percentages:
    • Trunk (front): 18%
    • Trunk (back): 18%
    • Each Arm: 9%
    • Each Leg: 18%
    • Genitalia: 1%
    • Head and Neck: 9%

Coding Exercise Examples

Example 1:

  • Patient with second-degree burns on leg and third-degree burns on back
  • Descriptions:
    • 30% TBSA burned
    • 11% third-degree
  • Coding process includes: Identifying the degree, location, sequencing, and using guidelines from MCG manual
    • Solutions: Code sequences discussed

Example 2 (Scenario given):

  • Cooking accident resulting in burns from pressure cooker steam
  • First, second, and third-degree burns on trunk
  • Summary Process:
    • Identify key terms, references, extent of burns, and correct codes
    • Example highlighted details like location, severity, and external cause

Key Takeaways

  • Prioritize coding according to severity and location
  • Use the rule of nines for TBSA calculations
  • Follow guidelines from MCG manual closely
  • Practice with real scenarios for better understanding

Closing Remarks

  • Continuous practice and referencing guidelines crucial for accuracy
  • Thank you for attending this session

Brought by AMCI