My doc and I are "disagreeing"- He is always stating he did partial thickness ulcer debridement, and wants it charged that way, however, in his notes he is stating "there is thickening of the skin on lt hallux upon debridement there is no open lesion at this time,this is a preulcerative lesion".

I am telling him it's part of the E/M as he is checking for an ulcer but not finding one, at the most I would say a callus debridement to look for ulcer underneath.

Any thoughts would be helpful, I am having a difficult time justifying in my mind charging out all kinds of ulcer debridements when he is stating right in the note that he did not find one???????