2025 HCPCS code A6217

Supply of non-impregnated, non-sterile gauze dressing; pad size >16 sq in, ≤48 sq in, without adhesive border.

Appropriate modifier selection (A1-A9 for number of wounds treated, AW if used with surgical dressing, LT/RT for extremity wounds).Proper documentation supports medical necessity.

Modifiers A1-A9 (number of wounds), AW (used with surgical dressing), LT (left side), RT (right side) are applicable.

Medical necessity for A6217 is established when the patient has an open wound requiring a dressing to absorb exudate, protect against infection, and promote healing.The size of the gauze dressing must be appropriate for the size of the wound.Documentation must support the medical necessity for the specific size of dressing used.

The clinical responsibility for this code lies with the healthcare professional who determines the medical necessity of the gauze dressing and either applies the dressing or provides instructions for self-application.This could include nurses, physicians, or wound care specialists.

IMPORTANT A6216 (≤16 sq in), A6218 (>48 sq in), A6219-A6221 (sterile, with adhesive border), A6222-A6224 (impregnated with substances other than water, normal saline, or hydrogel)

In simple words: This code covers the cost of a single gauze pad used to cover a wound.The pad is not sticky and is between a small and medium size.It's used to help wounds heal by keeping them clean and protected from germs.

This HCPCS code represents the supply of a single, non-impregnated, non-sterile gauze dressing. The pad size must be larger than 16 square inches but no more than 48 square inches, and it cannot have an adhesive border.The gauze is intended for wound care, including cleaning, absorbing exudate, and protecting the wound from infection.This code covers the supply of the dressing only; application is billed separately.

Example 1: A patient presents with a laceration requiring wound care. The physician cleans the wound and applies a gauze dressing (A6217) to absorb exudate and protect against infection. The dressing is secured with tape. , A patient with a pressure ulcer requires daily wound care.A nurse cleans the wound and applies a new A6217 gauze dressing, documenting the size and condition of the wound.The dressing is changed per the care plan., Following a surgical procedure, the surgeon applies A6217 gauze dressings to the incision site to absorb drainage and prevent infection. The patient is instructed on how to change the dressings at home.

* Documentation of the wound size and location.* Documentation of the type of wound (e.g., laceration, abrasion, pressure ulcer).* Documentation of the medical necessity for the gauze dressing.* Documentation of the application of the dressing (if performed by the provider).* Progress notes describing wound healing and any complications.

** This code should only be used for non-impregnated, non-sterile gauze dressings within the specified size range.Other gauze dressings are represented by different HCPCS codes.

  • Payment Status: Active
  • Modifier TC rule: Not applicable; this code represents supply only.
  • Specialties:Wound care, surgery, family medicine, general practice
  • Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Home
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