T31.43

Billable

Burns involving 40-49% of body surface with 30-39% 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 30-39% deep tissue damage (third degree burns). This represents a life-threatening injury with extensive full-thickness burns affecting a large portion of the body.

Coding Tips

•Document the need for aggressive fluid resuscitation and potential complications such as burn shock
•This severity level has high mortality risk and requires comprehensive documentation of all interventions

Clinical Significance

Burns involving 40-49% of body surface area with 30-39% third-degree burns represent catastrophic injury with grave prognosis requiring immediate life-sustaining interventions. This extensive pattern of full-thickness burns demands the highest level of specialized burn center care with complex multi-system support, extensive surgical reconstruction, and carries extremely high mortality rates even with optimal treatment.

Documentation Requirements

✓Documentation of 40-49% total body surface area involvement
✓Clear documentation that 30-39% of burned area is third-degree
✓Burn specialist assessment confirming extensive full-thickness involvement
✓Evidence of immediate life-sustaining interventions and resuscitation
✓Documentation of burn center admission with intensive care capability
✓Comprehensive surgical planning for extensive reconstruction
✓Assessment of associated injuries and systemic complications
✓Documentation of multidisciplinary team involvement and prognosis

Commonly Confused Codes

T31.42 — Burns 40-49% TBSA with 20-29% third degree (less third-degree involvement)T31.44 — Burns 40-49% TBSA with 40-49% third degree (all burns are third-degree)T31.33 — Burns 30-39% TBSA with 30-39% third degree (smaller total area)T32.43 — Corrosions 40-49% TBSA with 30-39% third degree (chemical cause)T31.53 — Burns 50-59% TBSA with 30-39% third degree (larger total area)

Code Hierarchy

└T31Burns classified according to extent of body surface involved └T31.4Burns involving 40-49% of body surface └T31.43Burns involving 40-49% of body surface with 30-39% third degree burns

└T31.43Burns involving 40-49% of body surface with 30-39% third degree burns