Pediatric Coding:  Code This Campfire Injury Correctly

Case Overview

A 13-year-old patient sustained second-degree burns on the upper back and entire right arm after tripping over firewood and falling into a campfire.

The physician performed burn debridement and applied a dressing.

Burn Injury Coding Requirements

When a burn involves multiple anatomical sites, coders must:

• Assign separate ICD-10-CM codes for each burn location.
• Document the total body surface area (TBSA) affected by the burns.
• Sequence the code representing the most severe burn first.

Example from this case:

The burns cover part of the upper back and the whole right arm, totaling more than 10% TBSA. This requires four location codes plus two additional codes, for a total of six ICD-10-CM codes.

ICD-10-CM Codes for This Case

1. T21.23XA - Burn of second degree of upper back, initial encounter
2. T22.231A - Burn of second degree of right upper arm, initial encounter
3. T22.221A - Burn of second degree of right elbow, initial encounter
4. T22.211A - Burn of second degree of right forearm, initial encounter
5. T31.10 - Burns involving 10–19% of body surface with 0% to 9% third degree burns
6. X03.0XXA - Exposure to flames in controlled fire, not in building or structure, initial encounter

Official ICD-10-CM Guidelines to Follow

Guideline I.C.19.d.1 - "Sequence first the code that reflects the highest degree of burn when more than one burn is present."

Guideline I.C.19.d.2 - "Assign to the highest degree in instances when different degrees of burn occur at the same anatomical site."

Key Takeaways for Coders

• Constantly sequence by severity first.
• Use multiple codes when different areas are affected by fire.
• Document TBSA to ensure accurate coding.

Maximize Reimbursements with BillingFreedom’s Pediatric Coding Specialists

Accurate coding plays a crucial role in the success of pediatric medical billing, particularly when handling complex cases such as multi-site burn injuries. At BillingFreedom, our pediatric coding specialists strictly adhere to ICD-10-CM guidelines, ensuring that every code accurately reflects the correct location, severity, and percentage of Total Body Surface Area (TBSA) affected. This approach enhances claim accuracy, facilitates full compliance, and provides the clinical details that payers require.

By maintaining a clean claim rate of up to 98%, pediatric practices benefit from faster reimbursements, reduced Accounts Receivable (AR) days, and fewer claim denials. Our focus on correct sequencing, site-specific documentation, and adherence to guidelines allows providers to capture the full scope of services rendered. This results in a healthier revenue cycle, stronger audit readiness, and clear, accurate patient records, all essential for sustaining high-quality pediatric care delivery.

For more details about our exceptional Pediatric medical billing services, please don't hesitate to contact us via email at info@billingfreedom.com or call us at +1 (855) 415-3472. 

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