Coding and coverage resources.
Coding information is provided for reference. Confirm the applicable product code, payer policy, benefit requirements, billing setting and documentation before submitting a claim. A HCPCS code does not guarantee coverage or payment.
By product
| Product | HCPCS | Coverage notes |
|---|---|---|
| Advanced Diabetic Wound Hydrogel 3 fl oz (90 ml) |
A6248 | Under the Medicare surgical dressings LCD, the maximum is 3 fluid ounces per wound in 30 days. This is a limit, not a monthly entitlement: clinical and benefit criteria still apply. |
| Advanced MultiCare Hydrogel 3 fl oz (90 ml) |
A6248 | Under the Medicare surgical dressings LCD, the maximum is 3 fluid ounces per wound in 30 days. This is a limit, not a monthly entitlement: clinical and benefit criteria still apply. |
| Advanced Post-Procedure Skin Barrier Gel 3 fl oz (90 ml) |
A6250 | Medicare does not cover A6250 skin barriers under the surgical-dressing benefit. Any other payer needs a specific, current policy for your setting. |
Dressings applied as part of a billed professional service are not separately payable under that policy. Confirm the code assignment for each product with the payer. For coding questions, contact our team.
The setting decides how a product is billed
Supplies for home use
Dressings furnished to a patient for home dressing changes may be billed under the surgical dressings benefit, where the benefit, qualifying wound and documentation requirements are met.
Applied in the office
Dressings applied during a billed professional service are included in that service and are not separately payable under the Medicare surgical dressings policy.
Review before you submit
Confirm the product code, payer policy, benefit, billing setting and documentation for your situation before submitting any claim.
Talk to our team
We can share coding reference information. Coverage and payment are decided by the payer.
Questions about billing?
Our team can share coding reference information for your practice setting.