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There's more to the procedures than dressing, debridement – at times almost $900 more. In case you're reporting 16000-16036 codes, you might be losing pay -- nearly $900 -- for distinctly reimbursable procedures, as procedures like skin grafts are not involved in these codes. Our experts provide dermatology coding and billing tips for improving your burn treatment reimbursement. Dermatology Coding Tip 1: Size Defines Anesthesia Code Choice In case the doctor merely debrides a burn, you must choose a primary treatment code from the 16000-16030 series. Reason: Pick 16000 (Initial treatment, first-degree burn, when no more than local treatment is required) when the physician inclines to a first-degree burn only (burns affecting only the epidermis). As far as extensive burns are concerned, you should select among codes 16020 (Dressings and/or debridement of partial-thickness burns, initial or subsequent; small [less than 5% total body surface area]), 16025 (… medium [e.g., whole face or whole extremity, or 5% to 10% total body surface area]), or 16030 (... large [e.g., more than 1 extremity, or greater than 10% total body surface area]). Don't miss: In order to find the percentage of skin that is involved, use the "Rule of Nines". AS per the rule: head along with the neck, the right arm, as well as the left arm each equal 9 percent the back trunk along with the front trunk, left leg, along with the right leg each equal 18 percent (the front and back trunk are divided into upper and lower segments, and each leg is divided into back and front segments, each equaling 9 percent) genitalia equivalents 1 percent. Select the treatment code based on that percentage. One more thing: Ensure that the dermatologist evidently states the size of the area(s) that are affected in the documentation to support any code selection. Dermatology Coding Tip 2: Claim Skin Grafts When Appropriate Codes 16000-16036 just define the treatment of the burn surface, thus you might report skin grafts provided the physician carries out them. You must choose the suitable skin graft code(s) from the 15040-15431 portion of CPT® -- if you are not doing it, it could weaken your reimbursement and you could lose your well-deserved pay. One more thing: You must report 15002-15005 (Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar [including subcutaneous tissues], or incisional release of scar contracture ...) as correct when the physician surgically prepares the recipient site. Though: As per the Correct Coding Initiative (CCI), you can only use the treatment codes or the site prep codes at one time so use the most proper code. Dermatology Coding Tip 3: Treat Subsequent Sessions as Staged Procedures For follow-up procedures, you might have to append modifier 58 (Staged or related procedure or service by the same physician during the postoperative period). Want to get more tips like these to master dermatology billing and coding? Click here to read the entire article and to get access to our monthly Dermatology Coding Alert: Your practical adviser for ethically optimizing dermatology billing and coding, payment, and efficiency for dermatology practices Read more to know everything about dermatology ICD-9 codes and perfect your dermatology billing and coding: http://www.supercoder.com/articles/articles-alerts/der/burn-treatments-16000-16030-may-not-tell-entire-burn-treatment-story-107505/
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