2025 HCPCS code A5
Modifier A5 is appended to a HCPCS code to identify a surgical dressing used for dressing five wounds.
Modifier A5 is used in conjunction with HCPCS codes for surgical dressings.
Medical necessity for the surgical dressings should be documented based on the condition of the wounds and the clinical rationale for using the specific dressing.
The provider applying the surgical dressing is responsible for using the appropriate modifier.
In simple words: The code A5 is used when a healthcare professional applies a dressing to five separate wounds.It's added to the main code for the dressing itself to show how many wounds it was used on.
This modifier indicates that a particular surgical supply used by the provider is a dressing on a wound. It also indicates the number of wounds on which the provider is using the dressing, or the number of wounds a durable medical equipment (DME) supplier is providing a supply for. Use A5 with the appropriate HCPCS code when the provider uses a surgical supply for dressing five wounds. The modifier number corresponds to the number of wounds a surgical dressing is applied to.The modifier a provider uses corresponds to the number of wounds on which the provider is using the dressing, not the total number of wounds that the provider treats.
Example 1: A patient presents with five lacerations on their right arm. The physician cleans and dresses each laceration. Modifier A5 would be appended to the HCPCS code for the surgical dressing used., A patient has five separate surgical incisions following a complex procedure.A DME supplier provides dressings for each of these wounds. Modifier A5 is used with the HCPCS code for the dressings provided., A patient with five infected ulcers on their leg receives wound care. The nurse debrides the wounds and applies surgical dressings.Modifier A5 is appended to the appropriate HCPCS code for the dressings applied.
Documentation should support the number of wounds dressed and the medical necessity for the specific type of dressing used.The location and size of each wound should be clearly documented.
** Accurate application of this modifier is critical for proper reimbursement. Incorrect use can lead to claim denials or underpayments.
- Specialties:Many specialties can use this modifier, including surgery, wound care, and podiatry.
- Place of Service:Physician's office, hospital outpatient department, skilled nursing facility, and other places of service.