2025 HCPCS code A6247

Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing.

For wounds smaller than 48 sq. inches, use A6245 (16 sq. in. or less) or A6246 (more than 16 sq. in. but less than or equal to 48 sq. in.)For hydrogel wound filler, use A6248. Do not report A6247 if multiple types of hydrogel dressings are used on the same wound at the same time.

Modifiers may be applicable. Refer to HCPCS modifier guidelines for appropriate use.

Medical necessity for hydrogel dressings is established when used on wounds exceeding 48 sq. inches with little or no drainage, typically full-thickness wounds (stage III or IV ulcers).The use of adhesive border is justified for ease of application, minimizing disruption to the wound bed during changes, and reducing pain.

In simple words: This code covers a large hydrogel dressing (more than 48 square inches) with a sticky border, used to cover and protect wounds while keeping them moist to help them heal. It is often used for wounds that aren't producing a lot of fluid.

Hydrogel dressing is a sterile wound cover used to dress a wound and regulate fluid exchange with the wound surface. This code covers the supply of a dressing greater than 48 sq. inches in size with an adhesive border of any size. It is typically used on wounds with minimal to no exudate following surgical procedures or debridement of non-healing wounds.The adhesive border allows for secure placement and less painful dressing changes.

Example 1: A patient with a large surgical wound (e.g., greater than 48 sq. inches) requires a hydrogel dressing to promote healing and minimize pain during dressing changes. A6247 is reported for each dressing supplied., A patient with a chronic, non-healing wound exceeding 48 sq. inches with minimal exudate requires a hydrogel dressing. The adhesive border ensures the dressing stays in place and minimizes trauma to the wound during dressing changes. A6247 is billed for each dressing., Following debridement of a large burn wound (greater than 48 sq. inches) a hydrogel dressing with adhesive border is applied to promote a moist healing environment and reduce pain. A6247 is used to report each dressing supplied.

Documentation should support the medical necessity of the hydrogel dressing, including wound size, location, type, and the presence of minimal or no exudate. The size of the dressing (greater than 48 sq. inches) should also be documented. For Medicare claims, documentation of medical necessity may be required for submission to the DMERC if the dressing changes are sent home with the patient. If the dressing is part of a kit, documentation needs to indicate which components were used and deemed medically necessary.

** For dressings dispensed to be taken home, claims can be submitted using the patient's place of residence as the place of service. HCPCS codes should be used to report the supply of the dressing, not the application or changing of the dressing. Refer to HCPCS coding guidelines for proper documentation and billing.

  • Place of Service:Applicable place of service codes depend on where the dressing is applied (e.g., "Inpatient Hospital", "Office", "Home", "Outpatient Hospital", etc.). If sent home with the patient, use the place of service corresponding to the patient's residence, not "Office".
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