2025 HCPCS code A6221

Non-impregnated gauze dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing.

Use modifiers A1-A9 to indicate the number of wounds dressed, not the total number of wounds present. Append modifier AW if furnished in conjunction with a surgical dressing. Append modifier LT or RT for extremity wounds. For dressings sent home with the patient, indicate place of service as the patient’s residence (POS 12).

Modifiers A1-A9 are used to report the number of wounds dressed, AW for use with surgical dressings, and LT or RT to specify left or right side for extremity wounds.

Medical necessity for gauze dressings is established by the presence of an open wound requiring covering, protection from infection, or absorption of exudate. The size of the dressing should be appropriate for the size of the wound.

Report this code when the patient receives the application of a non-impregnated gauze dressing to cover open wounds. This dressing can be used to scrub, wipe, or absorb exudate and protect a wound from bacterial infection. It can also be sent home with the patient for self-application. The size of the dressing must be appropriate to the wound size.

IMPORTANT Use codes A6216 to A6218 for non-impregnated gauze dressing without adhesive material. Use A6219 for gauze pads 16 square inches or less with adhesive border. Use A6220 for gauze pads more than 16 but less than or equal to 48 square inches with adhesive border. Use A6222 to A6224 for gauze dressings impregnated with hydrogel or normal saline. Use A6266 for gauze impregnated with substances other than water, normal saline or zinc paste.

In simple words: Sterile gauze dressing, larger than 48 square inches, with an adhesive border, used to cover and protect wounds.

Supply of non-impregnated sterile gauze dressing with a pad size of more than 48 square inches and any size adhesive border, used to dress an open wound, scrub, wipe, or absorb exudate.Applied to a wound, gauze helps protect the wound from bacterial infection.

Example 1: A patient with a large abrasion on their leg receives a sterile gauze dressing larger than 48 square inches with an adhesive border to cover and protect the wound., A patient undergoes a surgical procedure, and a large incision is dressed with sterile gauze exceeding 48 square inches and secured with an adhesive border., A patient with a chronic wound requires a large, absorbent dressing. A sterile gauze pad exceeding 48 sq. inches with an adhesive border is applied to absorb exudate and protect the wound.

Document the size of the wound and the size of the dressing applied.If the dressing is impregnated, specify the impregnating agent. Document the medical necessity of the dressing, such as the presence of an open wound, the need to absorb exudate, or protect the wound from infection.

  • Specialties:Wound care, general surgery, and any specialty managing open wounds.
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Home, and other places where wound care is provided.
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