Skip to Main Content

Print | Bookmark | Font Size: + | –

November 20, 2025

Medical Review Bulletin: Collagen Dressing A6023 – Key Denial Trends and Compliance Tips

HCPCS Code A6023 refers to a sterile collagen dressing larger than 48 square inches, used in wound care for full-thickness wounds, wounds with light to moderate exudate, or wounds that have stalled or have not progressed toward a healing goal. While collagen dressings are clinically valuable, claims for A6023 are frequently denied due to documentation and coding issues. This bulletin outlines the top denial reasons and provides actionable guidance to support compliant billing and clinical use.

  • Top Denial Reasons for A6023
    1. Incorrect Dressing Size

      The most common denial for A6023 is due to a mismatch between the wound size and the dressing size billed. A6023 is intended for wounds requiring dressings larger than 48 square inches.

      Best Practice:

      • Make sure the wound measurements support the use of a dressing of this size.
      • Document the wound dimensions clearly and justify the need for a larger dressing, especially if used to cover periwound areas or multiple wounds.
      • Dressing size must be appropriate to the wound size.
    2. Inconsistent Wound Measurements

      Denials often result from wound measurements that do not reflect the wound at the time of dressing application. Measurements taken before surgical closure or during earlier stages of care are insufficient.

      Best Practice:

      • Document wound size (length × width × depth) on the date of dressing application.
      • Weekly wound evaluations are expected for patients in nursing facilities or with heavily draining/infected wounds.
      • Include wound type, location, drainage level, and other relevant clinical details.
    3. Use of Collagen Over Skin Sealant

      Collagen dressings are not covered when applied over skin sealants or barriers as this interferes with the dressing’s therapeutic function.

      Best Practice:

      • Apply collagen dressings directly to the wound.
      • Avoid layering over products that do not meet the definition of surgical dressing.
      • Document that the dressing is used as a primary or secondary dressing on a qualifying wound.
  • Documentation Checklist for A6023

    To support medical necessity and avoid denials, make sure the following are documented:

    • Type and location of the qualifying wound
    • Wound size (length × width × depth) at time of dressing application
    • Drainage level (light to moderate for collagen)
    • Dressing type and size
    • Frequency of dressing change
    • Use as primary or secondary dressing
    • Physician’s signed order
    • Monthly updates and weekly evaluations (if applicable)
  • PDAC Product Classification List (PCL) Requirement

    For claims with dates of service on or after June 1, 2013, A6023 requires a written Coding Verification Review (CVR) by the Pricing, Data Analysis and Coding (PDAC)External Website contractor and must be listed on the Product Classification List (PCL).

    Best Practice:

    • Verify that the collagen product billed under A6023 is listed on the PDAC PCL.
    • Final Compliance Tips
      • Use A1–A9 modifiers to indicate the number of qualifying wounds treated.
      • Avoid billing for collagen dressings used in non-covered scenarios (e.g., over intact skin or non-qualifying wounds).
      • Monitor wound progress and adjust dressing type and quantity as clinically indicated.
      • Ensure PDAC verification for all collagen products billed under A6023.
    • Conclusion:
      By addressing these common denial reasons and adhering to CMS documentation and coding standards, providers can improve claim success and ensure appropriate wound care delivery.

Resources:

Publication History

November 20, 2025 Revised to clarify coverage criteria for A6023
November 2, 2025 Original Publication

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved