T20.319A — Burn of third degree of unspecified ear [any part, except ear drum], initial encounter
Is T20.319A billable?
Yes, but T20.319A will trip a Medicare edit. T20.319A is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists T20.319A under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
T20.319A at a glance
| Code | T20.319A |
|---|---|
| Description | Burn of third degree of unspecified ear [any part, except ear drum], initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T20.319A?
In T20.319A, the 7th character A means initial encounter. The 7th character is required for T20.319A to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
What Medicare edits apply to T20.319A?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name T20.319A directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does T20.319A group to?
T20.319A sits in MDC 22 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 927Extensive Burns or Full Thickness Burns with MV >96 Hours with Skin Graftsurgical
- 933Extensive Burns or Full Thickness Burns with MV >96 Hours without Skin Graftmedical
As a secondary diagnosis, T20.319A is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG. It also carries Hospital-Acquired Condition category 05.
How is T20.319A listed in the Alphabetic Index?
The Alphabetic Index lists these routes under T20.31, the nearest indexed parent of T20.319A. Use them to find the family, then select the specific code.
- Burn › ear › third degree (electricity) (flame) (hot gas, liquid or hot object) (radiation) (steam) (thermal)
Use additional code — inherited from Chapter 19
Report an additional code alongside T20.319A to fully describe the condition. T20.319A is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T20-T25
Report an additional code alongside T20.319A to fully describe the condition. T20.319A is sequenced first.
Use additional code — inherited from T20.3
Report an additional code alongside T20.319A to fully describe the condition. T20.319A is sequenced first.
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T20.319A, but a patient may have both at the same time. When documentation supports it, T20.319A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T20
The conditions below are not part of T20.319A, but a patient may have both at the same time. When documentation supports it, T20.319A and the excluded code may both be reported.
Excludes2 — not included here — inherited from T20.31
The conditions below are not part of T20.319A, but a patient may have both at the same time. When documentation supports it, T20.319A and the excluded code may both be reported.
- burn of ear drum (T28.41-)
How long has T20.319A existed?
T20.319A has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.