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T31.98 ICD-10-CM Code: Burns involving 90% or more of body surface with 80-89% third degree burns

T31.98 maps to CMS-HCC V28 385. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupT31.98

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)

T31.98

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Burns involving 90% or more of body surface with 80-89% third degree burns

Severe burns covering 90% or more of the body with 80-89% being third-degree burns with nearly complete full-thickness involvement.

Buddy the Bee presenting code insight

Buddy Insight

Burns involving 90% or more of body surface area with 80-89% third-degree burns represent near-maximum catastrophic thermal injury with survival extremely unlikely even with optimal care.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 385

Coefficient HCC 385: 1.291 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 218

Code-level coefficient reference

ESRD/PACE

HCC 162

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
T31Burns classified according to extent of body surface involvedT31.9Burns involving 90% or more of body surfaceT31.98Burns involving 90% or more of body surface with 80-89% third degree burns

Inclusion Terms

Official

No inclusion terms are included in this display for T31.98. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • birth trauma (P10-P15)Inherited from S00-T88
  • obstetric trauma (O70-O71)Inherited from S00-T88

Related Codes

Official
T31.90Burns involving 90% or more of body surface with 0% to 9% third degree burnsT31.91Burns involving 90% or more of body surface with 10-19% third degree burnsT31.92Burns involving 90% or more of body surface with 20-29% third degree burnsT31.93Burns involving 90% or more of body surface with 30-39% third degree burnsT31.94Burns involving 90% or more of body surface with 40-49% third degree burns

Includes

Official

No Includes notes are included in this display for T31.98. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for T31.98. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for T31.98. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code to identify any retained foreign body, if applicable (Z18.-)Inherited from S00-T88

Code Also

Official

No Code Also instructions are included in this display for T31.98. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of 90% or greater total body surface area involvement
Clear documentation that 80-89% of body surface has third-degree burns
Burn specialist confirmation of the near-maximum severity injury
Evidence of extraordinary life support and resuscitation measures

MEAT Support

HCC Buddy guidance
Documentation of 90% or greater total body surface area involvement
Clear documentation that 80-89% of body surface has third-degree burns
Burn specialist confirmation of the near-maximum severity injury
Evidence of extraordinary life support and resuscitation measures

Audit Caution

HCC Buddy guidance
Extreme difficulty in accurate assessment of such extensive injuries
Not recognizing the virtually universally fatal nature of this injury
Inadequate documentation of the extraordinary resource requirements
Failing to distinguish between thermal and chemical injury mechanisms

Common Mistakes

HCC Buddy guidance
T31.97 — Burns 90%+ TBSA with 70-79% third degree (less third-degree involvement)
T31.99 — Burns 90%+ TBSA with 90%+ third degree (maximum severity)
T31.88 — Burns 80-89% TBSA with 80-89% third degree (smaller total area)
T32.98 — Corrosions 90%+ TBSA with 80-89% third degree (chemical cause)

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is T31.98 an HCC code?

Yes. T31.98 (Burns involving 90% or more of body surface with 80-89% third degree burns) maps to HCC 385, Severe Skin Burn or Condition under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 1.291. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: T31.98 is billable and maps to V28 HCC 385, Severe Skin Burn or Condition. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
T31.98
Description
Burns involving 90% or more of body surface with 80-89% third degree burns
HCC (V28)
HCC 385 — Severe Skin Burn or Condition
RAF reference coefficient
1.291
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 385, Severe Skin Burn or Condition
1.291
ESRDHCC 162, Severe Skin Burn or Condition
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work T31.98 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for T31.98

For T31.98, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

T31.98 is the ICD-10-CM diagnosis code for burns involving 90% or more of body surface with 80-89% third degree burns. Severe burns covering 90% or more of the body with 80-89% being third-degree burns with nearly complete full-thickness involvement. T31.98 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, T31.98 maps to Severe Skin Burn or Condition (HCC 385) with a source-labeled community, non-dual, aged reference coefficient of 1.291. No V24 mapping is shown for T31.98; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document prognosis and treatment goals clearly in medical record. For T31.98, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for T31.98 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Document prognosis and treatment goals clearly in medical record
  • •Include all secondary diagnoses related to burn complications and systemic effects

Clinical Significance

Burns involving 90% or more of body surface area with 80-89% third-degree burns represent near-maximum catastrophic thermal injury with survival extremely unlikely even with optimal care. This injury pattern involves almost complete skin destruction across the majority of the body surface, requiring extraordinary life support measures and typically necessitating comfort care discussions alongside any aggressive interventions.

Documentation Requirements

  • ✓Documentation of 90% or greater total body surface area involvement
  • ✓Clear documentation that 80-89% of body surface has third-degree burns
  • ✓Burn specialist confirmation of the near-maximum severity injury
  • ✓Evidence of extraordinary life support and resuscitation measures
  • ✓Documentation of burn center admission with maximum care capability
  • ✓Assessment of treatment viability and realistic outcome expectations
  • ✓Documentation of family conferences regarding prognosis and care goals
  • ✓Comprehensive documentation of all interventions and supportive care

Commonly Confused Codes

  • •T31.97: Burns 90%+ TBSA with 70-79% third degree (less third-degree involvement)
  • •T31.99: Burns 90%+ TBSA with 90%+ third degree (maximum severity)
  • •T31.88: Burns 80-89% TBSA with 80-89% third degree (smaller total area)
  • •T32.98: Corrosions 90%+ TBSA with 80-89% third degree (chemical cause)
  • •T31.96: Burns 90%+ TBSA with 60-69% third degree (much less third-degree)

Child Codes

T31.90Burns involving 90% or more of body surface with 0% to 9% third degree burns
T31.91Burns involving 90% or more of body surface with 10-19% third degree burns
HCC 385
T31.92Burns involving 90% or more of body surface with 20-29% third degree burns
HCC 385
T31.93Burns involving 90% or more of body surface with 30-39% third degree burns
HCC 385
T31.94Burns involving 90% or more of body surface with 40-49% third degree burns
HCC 385
T31.95Burns involving 90% or more of body surface with 50-59% third degree burns
HCC 385
T31.96Burns involving 90% or more of body surface with 60-69% third degree burns
HCC 385
T31.97Burns involving 90% or more of body surface with 70-79% third degree burns
HCC 385
T31.98Burns involving 90% or more of body surface with 80-89% third degree burns
HCC 385
T31.99Burns involving 90% or more of body surface with 90% or more third degree burns
HCC 385

Code Hierarchy

└T31Burns classified according to extent of body surface involved└T31.9Burns involving 90% or more of body surface└T31.98Burns involving 90% or more of body surface with 80-89% third degree burns
└T31.98Burns involving 90% or more of body surface with 80-89% third degree burns

Also searched as

  • T31 98
  • T3198

For T31.98, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

T31.98 maps to CMS-HCC V28 category 385, Severe Skin Burn or Condition. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for T31.98. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work T31.98 in HCC Buddy

Open T31.98 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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