How To Use HCPCS Code A6011

HCPCS code A6011 describes a collagen-based wound filler in the form of a gel or paste, which is measured and billed per gram of collagen used. This code falls under the category of surgical dressings and is subject to specific coverage instructions. It was added to the Healthcare Common Procedure Coding System on January 1, 2003, with an effective date of January 1, 2011. HCPCS code A6011 is used to identify and bill for the application of collagen gel or paste as a wound filler.

1. What is HCPCS A6011?

HCPCS code A6011 is a specific code used to identify and bill for collagen-based wound fillers in the form of a gel or paste. It is important to note that this code is only applicable for the measurement and billing of collagen per gram used in the wound filling process. It is not intended for other types of wound dressings or treatments.

2. Official Description

The official description of HCPCS code A6011 is “Collagen-based wound filler, gel/paste, per gram of collagen.” The short description for this code is “Collagen gel/paste wound filler.”

3. Procedure

1. Prepare the wound: Before applying the collagen gel or paste, the healthcare provider should clean and prepare the wound according to standard wound care protocols.
2. Measure the collagen: The provider should measure the amount of collagen gel or paste required for the wound based on the wound size and depth.
3. Apply the collagen: Using sterile gloves or a clean applicator, the provider should apply the collagen gel or paste directly to the wound bed, ensuring complete coverage.
4. Secure the dressing: Once the collagen is applied, the provider should secure the wound dressing using appropriate techniques and materials.
5. Document the procedure: It is essential for the healthcare provider to accurately document the application of collagen gel or paste, including the amount used and any specific instructions or observations related to the wound.

4. When to use HCPCS code A6011

HCPCS code A6011 should be used when collagen gel or paste is applied as a wound filler. This code is specifically for collagen-based products and should not be used for other types of wound dressings or treatments. It is important to follow the specific coverage instructions for this code and ensure that the collagen gel or paste is measured and billed per gram of collagen used.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6011, healthcare providers should ensure that the following documentation requirements are met:

• Accurate measurement of the collagen gel or paste used in grams.
• Documentation of the wound size and depth.
• Clear description of the wound filling procedure and any specific instructions or observations related to the wound.

Providers should also follow the appropriate billing guidelines and submit the claim with the correct coding and modifiers, if applicable, to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A6011 was added to the Healthcare Common Procedure Coding System on January 1, 2003. It has an effective date of January 1, 2011. As of the provided knowledge, there have been no maintenance actions taken for this code, indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code A6011 falls under the category of surgical dressings and is subject to pricing based on the pricing indicator code 35, which indicates that the price is subject to floors and ceilings. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS priced under one methodology.

Medicare and other insurance coverage for HCPCS code A6011 may vary. It is important for healthcare providers to check with the specific payer for coverage and reimbursement guidelines.

8. Examples

Here are five examples of when HCPCS code A6011 should be billed:

1. Example 1: A patient with a deep, non-healing wound requires the application of collagen gel as a wound filler. The provider measures and applies 5 grams of collagen gel. HCPCS code A6011 should be billed for the 5 grams of collagen used.
2. Example 2: A patient with a diabetic foot ulcer requires the application of collagen paste as a wound filler. The provider measures and applies 3 grams of collagen paste. HCPCS code A6011 should be billed for the 3 grams of collagen used.
3. Example 3: A patient with a surgical wound requires the application of collagen gel as a wound filler. The provider measures and applies 2 grams of collagen gel. HCPCS code A6011 should be billed for the 2 grams of collagen used.
4. Example 4: A patient with a pressure ulcer requires the application of collagen paste as a wound filler. The provider measures and applies 4 grams of collagen paste. HCPCS code A6011 should be billed for the 4 grams of collagen used.
5. Example 5: A patient with a traumatic wound requires the application of collagen gel as a wound filler. The provider measures and applies 6 grams of collagen gel. HCPCS code A6011 should be billed for the 6 grams of collagen used.