T31.95 — Burns involving 90% or more of body surface with 50-59% third degree burns
T31.95 is a billable, specific ICD-10-CM code for burns involving 90% or more of body surface with 50-59% third degree burns. It is valid for submission on a claim.
Risk adjustment
T31.95 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 385 Severe Skin Burn or Condition1.291 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
T31.95 is named in 9 Medicare coverage policies — 7 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A52438Billing and Coding: Tetanus Immunization
- A53065Billing and Coding: Outpatient Physical Therapy
How T31.95 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to T31.95.
- Burn›extent›90 percent or more›with 50-59 percent third degree burns
- Burn›unspecified site with extent of body surface involved specified›90 percent or more›with›50-59 percent third degree
Related codes at this level
Codes that share T31.9. If T31.95 is not quite right, the correct code is usually one of these.
- 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
- T31.92Burns involving 90% or more of body surface with 20-29% third degree burns
- T31.93Burns involving 90% or more of body surface with 30-39% third degree burns
- T31.94Burns involving 90% or more of body surface with 40-49% third degree burns
- T31.96Burns involving 90% or more of body surface with 60-69% third degree burns
- T31.97Burns involving 90% or more of body surface with 70-79% third degree burns
- T31.98Burns involving 90% or more of body surface with 80-89% third degree burns
- T31.99Burns involving 90% or more of body surface with 90% or more third degree burns
Questions about T31.95
- Is T31.95 a billable ICD-10-CM code?
- Yes. T31.95 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T31.95 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Burns and corrosions of multiple and unspecified body regions (T30-T32).