T21.21XA (Burn of second degree of chest wall, initial encounter) compared with T21.21XD (Burn of second degree of chest wall, subsequent encounter), from the official CMS tabular data. T21.21XA and T21.21XD code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. T21.21XA and T21.21XD code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| T21.21XABurn of second degree of chest wall, initial encounter | T21.21XDBurn of second degree of chest wall, subsequent encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Burn of second degree of chest wall, initial encounter is a billable ICD-10-CM diagnosis code (T21.21A). | Burn of second degree of chest wall, subsequent encounter is a billable ICD-10-CM diagnosis code (T21.21D). |
| 7th character | The appropriate 7th character is to be added to each code from category T21 | The appropriate 7th character is to be added to each code from category T21 |
| Includes | burns and corrosion of hip region burns and corrosions of first degree [erythema] burns and corrosions of second degree [blisters][epidermal loss] burns and corrosions of third degree [deep necrosis of underlying tissue] [full- thickness skin loss] | burns and corrosion of hip region burns and corrosions of first degree [erythema] burns and corrosions of second degree [blisters][epidermal loss] burns and corrosions of third degree [deep necrosis of underlying tissue] [full- thickness skin loss] |
| Use additional code | external cause code to identify the source, place and intent of the burn (X00-X19, X75-X77, X96-X98, Y92) code from category T31 or T32 to identify extent of body surface involved | external cause code to identify the source, place and intent of the burn (X00-X19, X75-X77, X96-X98, Y92) code from category T31 or T32 to identify extent of body surface involved |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources