CO-B15 denial code
The payer won't pay this service until a qualifying primary service has been received and paid.
“This service/procedure requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated. …”
Start 01/01/1995 · Last modified 07/01/2017 · X12 adjustment reason code list
What it usually means in behavioral health
In behavioral health, B15 almost always involves an add-on code: interactive complexity (90785), psychotherapy add-ons with E/M (90833, 90836, 90838), the crisis add-on (90840), or psychological testing add-ons.
An add-on code is paid only with its primary code. If the primary is missing from the claim, denied, or still processing, the add-on gets B15.
Common causes
- Add-on code billed without its primary code on the same claim
- The primary code was denied, so the add-on fell with it
- Primary and add-on split across separate claims that processed out of order
Correct and resubmit, or appeal?
Fix the primary first. Bill the add-on with its primary on the same claim; if the primary was denied, appeal or correct the primary, and the add-on follows.
What to do
Find the primary code the add-on depends on and its status.
Resolve the primary's denial, or rebill the pair together.
Set a charge-entry rule that blocks add-on codes billed alone.
Often seen with
- N20
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