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Wiki Leveling question - wound care

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hkcrabs

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Joplin, MO
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A patient has a venous statis ulcer, with Peripheral Vascular Disease (PVD). the ulcer is documented as stalled and requires debridement. The physician documented 8 exam points. The patient is established. Since there is only one wound, i would consider this a 99213. My physician disagrees and says this is a 99214 due to the debridement. Another coder here says this is a 99214 due to the PVD affecting the healing of the wound and the pvd is considered another problem. I still stand by 99213 as it is not a life threatening wound and coding PVD as another problem would be "double dipping" as he didn't prescribe any medications or do anything else to treat the PVD and he is a wound care physician. Thoughts on this situation? Does anyone have any resources to support any of these answers?
 
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