Pediatric Coding - Do Not Overlook 16000 For Sunburn Treatment

By Author: Angela Martin
Total Articles: 205
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Sunburns can possibly qualify for burn care in place of an E/M service if you meet certain guidelines. Answer the local treatment" question to potentially add $65 to your bottom line.


No extra care means any extra pay


Red skin, even an area that might technically be burned", does not automatically lead to reporting a burn treatment code.


Hint: if your staff does not administer treatment purposely for the sunburn, you may only go for an E/M code for the check. The correct code depends on the situation, however, you would most likely go for 99212 (Office or other outpatient visit for the evaluation and management of an established patient ).


Here's an instance: A mother brings her son to your office owing to his sunburned shoulders and back. Post examination, the pediatrician determines the burn is superficial and will heal on its own in some days time. She instructs the mother to have her son wear his shirt while outdoors. You will go for right E/M coding ...
... like 99212 for an established patient or 99201 (Office or other outpatient visit for the evaluation and management of a new patient ) for a new patient.


Topical Medication Hints to 16000


In the above example, if the child has more severe burn, his care might qualify for code 16000 (Initial treatment, first degree burn, when no more than local treatment is called for).


Hint: See whether your staff tends to the burn with topical medication (anesthetic) or other options.


For more tips on ways to code sunburn treatment and other pediatric coding know how, sign up for a pediatric coding conference that's slated to take place at Orlando, FL this December.