5. Fractures are classified as open or closed. Coding personnel should review the
descriptions in Volume 1, page 735, that are frequently used in diagnostic statements
that identify fractures as open or closed. Fractures not specified as open or closed are
coded as closed.
6. Categories 94-949 are provided for coding burns whether f rom chemicals or other
causes. Burns of the same anatomical site but of different degrees should be coded to
the appropriate subcategory identifying the most severe degree. If a burn is stated to
be infected, in addition to the code(s) used to identify the burn, also use code 958.3 to
identify the infection.
a. Category 948 is used to classify burns according to percent of body surface
involved. This category is primarily designed for use as an additional code with
categories 94-947 to indicate the percent of body surface involved. It may be used as
a solo code when the site of the burn is not specified, but the percentage of body
surface involvement is specified.
b. Category 948 is unique in the coding structure. This category is designed to be
used as a subcategory fourth-digit code or as a subclassification fifth -digit code
whichever is applicable. The fourth digit will be used to indicate total percent of body
surface burn. The fifth digit is for percent of body surface of third -degree burn. The
military coders will always assign a fifth digit when using this category. If the total
percent of body surface is specified and there is no percentage for third -degree burn or
the percent for third-degree burn is less than 10 percent, use the fifth digit "."
7. Cause of injury codes for any condition coded with codes 692.71, 8-999, V713-
V716, and E93-E949 codes will be taken from STANAG 2050. See Appendix B of
Triservice Disease and Procedure Coding Guidelines, ICD--9-CM , dated 1 January
1991.
8. Sequencing of Injuries.
a. Multiple injuries : the most severe or life-threatening injury is the principal
diagnosis.
b. If injuries are of equal importance, the principal diagnosis is the one for which a
definitive surgical or nonsurgical procedure is performed.
APPLICATION
1. Multiple coding is not used if the classification provides a combination code fully
describing all elements of the diagnostic or procedure narrative.
EXAMPLE:
DIAGNOSIS: Closed fracture of right radius and ulna
813.83
MD0753
A-44