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Need a qualifying service to bill 15275

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gcmc11528

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Brooksville, FL
We are getting a Medicare denial for CPT 15275 stating we need a qualifying service. Would this be the wound prep 15004? I'm not sure what exacty they are looking for, does anyone know what this the qualifying service would be?
 
gcmc11528 said:
We are getting a Medicare denial for CPT 15275 stating we need a qualifying service. Would this be the wound prep 15004? I'm not sure what exacty they are looking for, does anyone know what this the qualifying service would be?
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Not a podiatry coder, but in the CPT book 15725 has a list of "code also" notes - could one of these codes be what's needed, perhaps?

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Correct, you need to bill for the wound care product or procedure. We use the 15275 as the application when we bill for Q codes, you need to indicate what was applied or done. 15004 is surgical prep with a wound vac, so if that is what you did then yes it also has to be billed.
 
I agree with Morgan, you would need the Q code. Think of this like an injection where the Q code is the J code for Kenalog for example and the 15275 being the administration code 96372.
 
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