Diabetic Wound Care Diagnoses

When billing for Diabetic Wound Care; our LMRP suggests the patient need to have co morbidities to support the billing of the Wound Care.

Our physician is listing the following in his impression

Diabetes Mellitus

Ankle Ulcer

Peripheral Neuropathy

Venous Insufficiency

He debrides the wound

We are coding 11042

Dx: 250.80, 707.13, 337.1, 459.81

Upon audit; we were told we can only code what the physician treated; and he is not treating anything but the ulcer in the debridement; so we should only code the Ankle Ulcer.

We feel we can support the co morbidities with the HPI and Exam; and ICD 9 states to code comorbidities that affect patient care. (HPI states patient is referred for delayed healing due to DM, peripheral neuropathy; and Venous Insufficiency; and the exam indicates the presence of all 3; and all 4 dx are in the impression). The auditor is stating he must state they are causing the delay of healing in the impression; and if he doesn't we cannot code them?

This seemed odd to me as my training was you could use the whole note to support your billing? I thought I would check on how other coders are doing this before we respond to the auditor; or ask our physicians to document differently.

Thanks

Diabetic Wound Care Diagnoses