ICD code T22.332S – Burn of third degree of left upper arm

Found our content helpful?

Key takeaways

T22.332S is a billable ICD-10-CM code for a burn of third degree of the left upper arm, sequela. It has been valid since the 2026 edition took effect on October 1, 2025.

The 7th character ‘S’ means the patient is presenting with a late effect of a prior third-degree burn. The wound itself has healed.

Omitting the additional codes for external cause (X00-X19), place of occurrence (Y92), and activity (Y93) is a common cause of claim denial.

A sequela claim survives audit only when the note states the wound is healed and names the late effect.

Practice management software like Pabau integrates with Claim.MD, so burn sequela claims go out electronically with their external cause codes attached.

Code details at a glance

The table below captures the key reference data for T22.332S in one place. Use it to confirm validity before submitting a claim.

What the 7th character ‘S’ tells the payer

The 7th character tells the payer where the patient sits in the care continuum. Using the wrong one triggers an audit flag or a denial.

T22.332 has three 7th character variants. Each describes a distinct clinical scenario:

Documentation drives the move from D to S. The clinical record must state that the burn wound has healed. It must also state that the current presentation is a late effect of that prior injury. Without that causal link in the note, a sequela code will not survive audit review.

Clinical description: Third-degree burn of the left upper arm

A third-degree burn, also called a full-thickness burn, destroys the entire epidermis and dermis and extends into subcutaneous tissue.

The wound site typically appears leathery, dry, and insensate because the nerves are destroyed. Unlike first- or second-degree burns, third-degree injuries rarely heal without surgical treatment such as skin grafting.

When sequela coding applies, the burn wound itself is healed. The code captures the downstream consequences rather than an open wound. Common late effects that prompt a sequela encounter include:

• Hypertrophic or keloid scarring at the burn site
• Scar contracture limiting shoulder or elbow range of motion
• Chronic pain or paresthesia from peripheral nerve involvement
• Skin pigmentation changes or grafted-skin complications
• Functional limitation requiring physical or occupational therapy

Documentation for this code uses several equivalent terms. Watch for any of these phrasings in the chart:

• Third-degree thermal burn of the left upper arm, sequela
• Full-thickness burn of the left arm, late effect
• Burn scar of the left upper extremity
• Sequela of third-degree burn, left humerus region

Parent code and T22 hierarchy

T22.332S sits inside a structured hierarchy. Reading it from the top down confirms that the code you picked sits at the right specificity level. It also points you to the neighboring codes quickly.

Sibling and related ICD-10 burn codes

Laterality and encounter type both change the code, so the siblings below are worth knowing by sight. Coders slip in two ways here. They pick the right arm instead of the left, or they reach for the unspecified code when the chart names a side. A clean claim submission depends on choosing the right sibling.

T22.339S should only appear on a claim when the clinical note genuinely omits laterality. If the record documents “left upper arm,” use T22.332S rather than the unspecified code.

Coding guidelines and additional codes required for T22.332S

ICD-10-CM Chapter 19 conventions require additional codes alongside T22.332S wherever the external cause and activity context can be identified. Missing them is one of the most common reasons burn sequela claims are denied or returned.

Submit the following additional codes as applicable:

• External cause of the burn (X00-X19, X75-X77, X96-X98): Identifies the mechanism. X02 covers exposure to controlled fire in a building, and X10 covers contact with hot drinks or food.
• Place of occurrence (Y92): Documents where the original burn incident happened.
• Activity code (Y93): Captures what the patient was doing at the time of the original injury.
• External cause status (Y99): Indicates whether the injury happened at work, during leisure, or in another context, with Y99.8 for other status.

Those five codes assemble into one claim line, and the diagram below shows the order they take.

For sequela encounters, the external cause codes describe the original burn event rather than the current visit. Practices that submit electronically through Claim.MD can send T22.332S with its companion codes in one transmission.

Checking the common denial codes before submission is worth the minute it takes, because several of them flag missing external cause information.

Documentation requirements for T22.332S

Sequela burn claims usually fail audit over documentation rather than code choice. The clinical record must carry five specific elements for T22.332S to hold up under review.

• Confirmed healed wound state: The note must state that the original burn wound is healed, rather than still healing or under wound care. The clinician makes that determination and records it.
• Causal link to the prior burn: The note must tie the current condition to the prior third-degree burn of the left upper arm. A general reference to “scar tissue” without naming the causative burn is not enough.
• Late-effect specificity: Name the manifestation. “Scar contracture limiting shoulder abduction following healed third-degree burn, left upper arm” gives the coder and the payer a clear picture. “History of burn” does not support sequela coding.
• Laterality confirmation: The record must confirm the left side. The right arm and the unspecified arm are different codes.
• Original burn history: The record should reference the original burn event, even briefly. A problem-list entry or a prior encounter reference supports the causal chain.

Practices managing burn sequela patients across several visits benefit from claims management software that links diagnosis codes to the patient’s encounter history. That link is what surfaces a missing external cause code before the claim leaves the building.

How Pabau keeps burn sequela claims documented and submitted

Most practices code a sequela visit in one system and submit the claim in another. The coder opens the prior encounter to confirm the burn is healed, then re-keys the external cause codes into the billing screen. Each hop is a chance to drop Y92 or Y93.

Pabau, our practice management software, holds the clinical note, the diagnosis codes and the claim in one record. A coder opening the sequela encounter sees the original burn visit alongside it. The causal link is on screen rather than in a separate chart.

Claims go out electronically through our Claim.MD integration, with eligibility checks and ERA reconciliation in the same place. Your billing team spends less time re-keying codes and chasing remittances.

Submit burn sequela claims without re-keying codes

Pabau integrates with Claim.MD for electronic ICD-10-CM claim submission, eligibility checks and ERA reconciliation. Your billing team spends less time chasing denials.

Book a demo

Conclusion

Burn sequela claims turn on documentation more than on code selection. The difference between T22.332D and T22.332S is a clinical judgment, and it has to live in the physician note. Pick the right 7th character, attach the external cause codes, and make the causal link explicit.

Do that consistently and the T22.332S claims that used to come back stop coming back. Book a demo to see how Pabau tracks burn sequela documentation and submits the claim from the same record.

Continue your research

Coding another third-degree burn sequela? ICD-10 code T22.342S covers the left axilla, where the same 7th character rules apply.

Want to reduce claim denials across your practice? Denial management in healthcare outlines the most common denial triggers and how to resolve them upstream.

Looking to improve your billing documentation workflow? Medical billing compliance walks through documentation standards that keep audit-sensitive codes like T22.332S defensible.

Frequently asked questions