2025 HCPCS code A6223
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Medical Supplies - Gauze Dressings Medical and Surgical Supplies Feed
Sterile gauze dressing, impregnated with material other than water, saline, or hydrogel; pad size >16 sq in, ≤48 sq in, without adhesive border.
Modifiers such as AW (item furnished in conjunction with a surgical dressing) and LT/RT (left/right side) may be applicable.
Medical necessity for A6223 requires proper wound assessment, determination of the need for a specific dressing type and size, and the absence of readily available and equally effective alternatives. Documentation must demonstrate that the selected dressing is appropriate for the wound's characteristics (size, exudate level, location, and condition) and is essential for proper wound care.
The clinical responsibility lies with the physician or qualified healthcare professional who assesses the wound, determines the appropriate dressing size and type, and orders the application of the dressing.The application itself may be performed by nursing staff or the patient themselves (if appropriate).
In simple words: This code covers the cost of a special type of sterile gauze bandage used to dress a wound.The bandage is larger than a small square but not bigger than a standard sheet of paper, and it doesn't have a sticky edge.It's used to protect wounds, soak up fluids, and prevent infection.
This HCPCS code, A6223, represents a sterile gauze dressing impregnated with a substance other than water, normal saline, or hydrogel.The dressing's pad size is larger than 16 square inches but does not exceed 48 square inches, and it lacks an adhesive border.This code is used for wound care, specifically to cover open wounds, absorb drainage, and protect against infection. The size should be appropriate for the wound being treated.Medicare coverage requires medical necessity documentation.
Example 1: A patient presents with a deep laceration on their leg requiring a large, non-adhesive dressing to absorb drainage and promote healing. A6223 would be appropriate., A patient with a chronic venous ulcer requires a daily dressing change. A6223 may be used to represent the large, non-adhesive dressings employed., A post-surgical patient has an incision site that requires a large, non-adhesive dressing to protect from infection and allow for drainage. This code would be applicable.
Detailed medical record documentation is required, including:(1) Physician's order specifying the type and size of dressing, (2) Description of wound (location, size, depth, type of drainage), (3) Assessment of wound healing and any complications, (4) Justification of medical necessity (e.g., preventing infection, managing exudate), (5) Date and number of dressings supplied.
** Always ensure that the size of the dressing reported using this code accurately reflects the dimensions.Incorrect reporting based on size will impact reimbursement.Furthermore, this code does not include any adhesive component.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a supply code.
- Fee Schedule : The historical fee schedule data is not available in this dataset.Consult appropriate fee schedules and databases for details.
- Specialties:Wound care, surgery, general practice, dermatology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Home Health