T31.64

Billable

Burns involving 60-69% of body surface with 40-49% 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

Very severe burns affecting 60-69% of the body surface, with 40-49% being third-degree burns that destroy all skin layers.

Coding Tips

•These extensive burns have extremely high mortality rates and require specialized burn unit management
•Ensure all associated injuries and complications are documented and coded separately

Clinical Significance

This represents a life-threatening burn injury with massive body surface involvement and nearly half being full-thickness burns. These patients require immediate burn center management with intensive multidisciplinary care and have extremely high morbidity risk.

Documentation Requirements

✓Total body surface area (TBSA) calculated as 60-69%
✓Third-degree burns comprising 40-49% of body surface
✓Standardized burn assessment chart utilized
✓Complete anatomical burn mapping
✓Burn etiology and mechanism documentation
✓Comprehensive burn depth evaluation
✓Associated injuries and complications
✓Initial treatment protocols and responses

Commonly Confused Codes

T31.63 — 30-39% third-degree versus 40-49% third-degree T31.65 — 50-59% third-degree versus 40-49% third-degree T31.54 — Total TBSA 50-59% versus 60-69%T32.64 — Chemical corrosion versus thermal burn T31.74 — Total TBSA 70-79% versus 60-69%

Code Hierarchy

└T31Burns classified according to extent of body surface involved └T31.6Burns involving 60-69% of body surface └T31.64Burns involving 60-69% of body surface with 40-49% third degree burns

└T31.64Burns involving 60-69% of body surface with 40-49% third degree burns