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97597 or 11040 for Partial Thickness Excisional Debridement?

Question: Encounter notes indicate that the physician performed a partial thickness excisional debridement of a patient’s wound. Should I use 97597 or 11040 for this service?
Answer: Since the physician performed the debridement and the notes indicate that it was an excisional debridement, you should report 11040 (Debridement; skin, partial thickness) for the service.
Key: Physician role should […]

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Pssssssst. Payer Report Cards Are Out

If you know your payers’ strengths and weaknesses, you’re better equipped to fight denials and negotiate contracts that are in your best interest.
So check out the American Medical Association’s second annual National Health Insurer Report Card. The AMA has gathered data and rated large payers on criteria like payment timeliness, accuracy, claim edit sources and denials, […]

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  3. AMA Sues Aetna, Cigna for Out-of-Network Reimbursement RatesThe American Medical Association isn’t stopping with the $350 million…
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Diabetes Coding Blunders That Cause Denials

Do you know the 5 fourth digits for 250.xx you should avoid?

A diabetes diagnosis code shows up on millions of dollars worth of claims each year, and that number is climbing rapidly. Make sure you code correctly to get every penny your practice deserves for managing the disease and treating manifestations and related conditions.
Diabetes […]

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  2. Flow Chart: Tame the Diabetes Diagnosis Coding Beast When coding for diabetes (250.xx), the fourth and fifth…
  3. Anatomy for Coders: Diabetes Digest (249.00-250.93)Almost every coder deals with diabetes, so here’s a quick…
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