Health Information Management

Report burn treatment, E/M codes separately

APCs Insider, June 3, 2005

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Report burn treatment, E/M codes separately

QUESTION: The nurses in our emergency department apply the dressings for burn treatment. Is it acceptable to assign codes such as 16000, 16020, 16025, and 16030 for the facility services we provide?

Assigning levels for burn treatment in the emergency department is not specifically addressed in our evaluation and management (E/M) criteria.

ANSWER: Yes, it is appropriate for your facility to assign CPT codes 16000, 16020, 16025, and 16030 in order to report the local treatment of the burn wound itself. These codes are not intended for physician use only, and they do not include evaluation and management services involving history, exam, and medical decision making for concurrent systemic problems the patient experiences.

The usual pre- and post-procedural services--explaining procedures to the patient/family, supervising the patient's positioning and prepping; monitoring the patient's stability, as appropriate; and providing the patient with after care instruction--are included in the procedure code. Therefore, do not report them separately.

These codes have a payment status indicator of "T," meaning they represent significant procedures for which payment is allowed under the hospital outpatient prospective payment system (OPPS). Please note however that certain circumstances may warrant multiple reductions.

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