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Escharotomy is a surgical procedure performed by a physician to treat third-degree burns, which are characterized by the destruction of the skin's layers, resulting in a hardened and inelastic eschar. This rigid eschar can significantly impede circulation in the affected extremities, potentially leading to severe complications such as limb loss if not addressed promptly. Additionally, when the eschar forms on the chest, it can restrict respiratory function, increasing the risk of conditions like atelectasis or pneumonia. The procedure involves making one or more incisions through the eschar, extending along its entire length and down to the underlying viable subcutaneous tissue. This incision allows the underlying tissues to expand, alleviating pressure and restoring circulation. Following the incision, bleeding is managed, and the area is treated with Slivazine cream and appropriate dressings. If the escharotomy involves a limb, it is typically elevated to minimize swelling at the burn site. The CPT® code 16035 is designated for the initial escharotomy incision, while code 16036 is used for any subsequent incisions performed during the same surgical session.
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Escharotomy is indicated for patients suffering from third-degree burns, particularly when the eschar becomes tight and rigid. This condition can lead to serious complications, including:
The escharotomy procedure involves several critical steps to ensure effective treatment of the burn area. Each step is designed to address the complications associated with tight eschar formation:
Post-procedure care following an escharotomy is essential for optimal recovery. Patients are monitored for any signs of complications, such as infection or excessive bleeding. The treated area should be kept clean and dry, with dressings changed as directed by the healthcare provider. Pain management may be necessary, and the physician will provide specific instructions regarding activity restrictions and follow-up appointments to assess healing. Additionally, ongoing evaluation of circulation and respiratory function is critical, especially if the escharotomy was performed on an extremity or the chest.
| Short Descr | INCISION OF BURN SCAB INITI | Medium Descr | ESCHAROTOMY FIRST INCISION | Long Descr | Escharotomy; initial incision | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6A - Minor procedures - skin | MUE | 1 | CCS Clinical Classification | 175 - Other OR therapeutic procedures on skin and breast |
This is a primary code that can be used with these additional add-on codes.
| 16036 | Addon Code MPFS Status: Active Code APC C Illustration for Code Escharotomy; each additional incision (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | T5 | Right foot, great toe | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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