Prevent RAC denials: Improve excisional debridement documentation

by Trey La Charité, MD
Every institution reading this column has likely received its first recovery audit contractor (RAC) denials regarding the documentation and coding of excisional debridement procedures (86.22). 

Our hospital is no exception. While we knew that this procedure was a specific and deliberate target of the RACs, we were not privy to the tactics they would use in an attempt to downgrade these procedures to the nonexcisional code (86.28). We now have a better understanding of the methodology the RACs employ to generate these denials. The following recommendations are based on our (a 500-bed academic medical center) experiences with the RAC denials we have received thus far for excisional debridements.