T31.42

Billable

Burns involving 40-49% of body surface with 20-29% third degree burns

HCC Category Mapping

V28HCC 385 — Severe Skin Burn or Condition

0.350

V24HCC 162 — Severe Skin Burn or Condition

0.517

ESRDHCC 162 — Severe Skin Burn or Condition

0.000

What This Code Means

Critical burns covering 40-49% of the body surface with 20-29% deep tissue damage (third degree burns). This is a life-threatening injury with substantial full-thickness burns requiring emergency surgical intervention.

Coding Tips

•Ensure documentation includes fluid resuscitation requirements and monitoring parameters for burns of this severity
•This level of injury typically requires immediate transfer to a specialized burn center

Clinical Significance

Burns involving 40-49% of body surface area with 20-29% third-degree burns represent critical burn injury with extremely high mortality risk requiring immediate life-saving interventions. This extensive burn pattern demands specialized burn center care with complex surgical reconstruction, intensive monitoring, and aggressive treatment of systemic complications including shock, organ failure, and infection.

Documentation Requirements

✓Clear documentation of 40-49% total body surface area involvement
✓Specific documentation that 20-29% of burned area is third-degree
✓Burn specialist assessment using standardized evaluation tools
✓Evidence of immediate burn center admission and intensive care
✓Documentation of life-saving interventions and resuscitation efforts
✓Surgical planning for extensive debridement and reconstruction
✓Assessment and management of multi-organ system complications
✓Documentation of prognosis and expected treatment course

Commonly Confused Codes

T31.41 — Burns 40-49% TBSA with 10-19% third degree (less third-degree involvement)T31.43 — Burns 40-49% TBSA with 30-39% third degree (more extensive third-degree)T31.32 — Burns 30-39% TBSA with 20-29% third degree (smaller total area)T32.42 — Corrosions 40-49% TBSA with 20-29% third degree (chemical cause)T31.52 — Burns 50-59% TBSA with 20-29% third degree (larger total area)

Code Hierarchy

└T31Burns classified according to extent of body surface involved └T31.4Burns involving 40-49% of body surface └T31.42Burns involving 40-49% of body surface with 20-29% third degree burns

└T31.42Burns involving 40-49% of body surface with 20-29% third degree burns