ICD 10 Diagnosis

🤔 Question: A patient presented with a contact burn injury from a muffler, but was also dragged by the vehicle that ran them over. They have an obvious third-degree contact burn to the abdomen and thigh and cutaneous injury in other parts of the body that are more consistent with friction injury.

For the Lund and Browder portion of BCQP, is the TBSA% of the area with the obvious contact burns recorded and not the areas with presumed friction injuries? Then, for the diagnosis, is the third-degree burns coded to the obvious areas of contact burns and then abrasion for the areas with friction injuries?

🌱 Answer: Only record the burn injuries on the Lund and Browder portion of the BCQP or other platforms. Do not record the non-burn friction areas on the Lund and Browder if the patient also has burn injuries as that will skew the burn data. The only time it is acceptable to record non-burn areas in the L&B chart is if the patient has no burn injury at all. In these circumstances, the case will not be pulled for burn for analysis, so it will not affect BCQP reporting (non-burn injuries are filtered out of TBSA analysis).
For Diagnosis Codes, record both the burn codes and the abrasion for the friction burns (non-burn codes).

🤔 Question: A patient presented with a contact burn injury from a muffler but also got dragged by the vehicle that ran them over. They have an obvious third-degree contact burn to the abdomen and thigh and cutaneous injury in other parts of the body that are more consistent with friction injury.

For the Lund and Browder portion of BCQP, is the TBSA% of the area with the obvious contact burns recorded and not the areas with presumed friction injuries? Then, for the diagnosis, is the third-degree burns coded to the obvious areas of contact burns and then abrasion for the areas with friction injuries?

🌱 Answer: Only record the burn injuries on the Lund and Browder portion of the BCQP or other platforms. Do not record the non-burn friction areas on the Lund and Browder if the patient also has burn injuries as that will skew the burn data. The only time it is acceptable to record non-burn areas in the L&B chart is if the patient has no burn injury at all. In these circumstances, the case will not be pulled for burn for analysis by BData, so it will not affect the analysis (non-burn injuries are filtered out of TBSA analysis).
For Diagnosis Codes, record both the burn codes and the abrasion for the friction burns (non-burn codes).

🤔 Question: Should complications entered into the Outcome Complications fields also be entered as ICD 10 codes in the Diagnosis field?

🌱 Answer: Complications entered in the outcome Complications fields may be entered in the ICD 10 diagnosis fields but do not have to be entered.

🤔 Question: If a patient, suspected of being abused, also has a fracture in addition to being burned, should the fracture be added in the diagnosis section?

🌱 Answer: Yes, you should add all the diagnoses on the patient, burn and non-burn, regardless of whether the patient is suspected of being abused.

ICD-10 Concomitant Injury Diagnoses

🤔 Question: How do you differentiate between ICD 10 Diagnosis Codes and ICD 10 Concomitant Injury Diagnosis Codes? For example, if you have a burn patient come in with shock and lactic acidosis, how would you sort these when entering them into the registry?

🌱 Answer: ICD 10 diagnosis codes are for the burn and non-burn (TEN, Necrotizing Fasciitis, etc.) diagnoses. Concomitant Injury Diagnoses are related to all other identified injuries which occurred at the time of the burn or non-burn injury. If conditions like shock and lactic acidosis are related to the burn injury, you would enter these under the ICD 10 diagnosis codes.

🤔 Question: What are the concomitant diagnosis codes? Are they everything except the burns diagnosis?

🌱 Answer: ICD 10 Diagnosis codes are for the burn and non-burn (TEN, Necrotizing Fasciitis, etc.) diagnoses.  Concomitant Injury Diagnoses are related to all other identified injuries which occurred at the time of the burn or non-burn injury.  Co-morbidities are pre-existing co-morbid factors present before patient arrival at the emergency department/hospital prior to the burn or non-burn injury. Comorbidities are not included in concomitant injury tracking. 

🤔 Question: Is history of revascularization/amputation for peripheral vascular disease, included for amputations or revascularizations due to diabetes?

🌱 Answer: If you are referring to this as a co-morbid condition, then it would be included if the reason for the amputation in a patient with diabetes was for a non-healing wound or there is a history of PVD as shown by abnormal ABI studies or clinical or physical exam consistent with claudication or venous stasis changes.
If an amputation occurs during the care of the burn injury, they should be included in the registry. The burn injury most likely contributed to the vascular issues that resulted in the amputation.