T31.62 ICD-10-CM Code: Burns involving 60-69% of body surface with 20-29% third degree burns
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Burns and corrosions of multiple and unspecified body regions (T30-T32)
T31.62
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBurns involving 60-69% of body surface with 20-29% third degree burns
Very severe burns affecting 60-69% of the body surface, with 20-29% being third-degree burns that destroy all skin layers.
Buddy Insight
This represents a critical burn injury with massive body surface involvement and significant full-thickness burns.
CMS-HCC V28
MappedHCC 385
RAF 0.350
CMS-HCC V24
MappedHCC 162
RAF 0.517
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 162
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for T31.62 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for T31.62 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for T31.62 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for T31.62 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for T31.62 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for T31.62 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for T31.62 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is T31.62 an HCC code?
Yes. T31.62 maps to Severe Skin Burn or Condition under the CMS-HCC V28 risk adjustment model (and Severe Skin Burn or Condition under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for T31.62
For T31.62to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed T31.62 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
T31.62 is the ICD-10-CM diagnosis code for burns involving 60-69% of body surface with 20-29% third degree burns. Very severe burns affecting 60-69% of the body surface, with 20-29% being third-degree burns that destroy all skin layers. T31.62 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering burns and corrosions of multiple and unspecified body regions (t30-t32).
Under the CMS-HCC V28 risk adjustment model, T31.62 maps to Severe Skin Burn or Condition (HCC 385) with a community, non-dual, aged base RAF weight of 0.350. Under the older V24 model, T31.62 mapped to the same category but with a base RAF weight of 0.517, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
These burns are life-threatening and require immediate transfer to a specialized burn center. Because T31.62 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for T31.62 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •These burns are life-threatening and require immediate transfer to a specialized burn center
- •Code any associated complications such as shock, infection, or respiratory compromise separately
Clinical Significance
This represents a critical burn injury with massive body surface involvement and significant full-thickness burns. These patients have extremely high morbidity and mortality requiring immediate specialized burn center care with comprehensive multidisciplinary management.
Documentation Requirements
- ✓Total body surface area (TBSA) calculated as 60-69%
- ✓Third-degree burns comprising 20-29% of body surface
- ✓Validated burn assessment tool documentation
- ✓Comprehensive anatomical burn distribution
- ✓Burn etiology and mechanism specification
- ✓Complete burn depth evaluation
- ✓Associated complications and injuries
- ✓Initial resuscitation and treatment protocols