How To Use HCPCS Code A6199

HCPCS code A6199 describes the use of alginate or other fiber gelling dressing as a wound filler. This sterile dressing is used to promote wound healing and provide a moist environment for optimal healing. In this article, we will explore the official description, procedure, when to use the code, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A6199?

HCPCS code A6199 is used to identify alginate or other fiber gelling dressing as a wound filler. This code is specifically used for surgical dressings and is subject to pricing floors and ceilings. It was added to the Healthcare Common Procedure Coding System on January 01, 1997, with an effective date of January 01, 2009. The code falls under the category of special coverage instructions, denoted by the coverage code D. The action code N indicates that no maintenance is required for this code.

2. Official Description

The official description of HCPCS code A6199 is “Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches.” The short description provided is “Alginate drsg wound filler.”

3. Procedure

1. Prepare the wound by cleaning it with an appropriate antiseptic solution.
2. Measure the size of the wound to determine the required length of the alginate or fiber gelling dressing.
3. Cut the dressing to the appropriate length, ensuring it covers the entire wound area.
4. Apply the sterile dressing to the wound, ensuring it adheres properly.
5. Secure the dressing in place with appropriate medical tape or bandages.
6. Instruct the patient on proper wound care and dressing change frequency.

4. When to use HCPCS code A6199

HCPCS code A6199 should be used when alginate or other fiber gelling dressing is used as a wound filler. This code is applicable for surgical dressings and is used to promote wound healing by creating a moist environment. It is typically used for wounds that have moderate to heavy exudate and require a dressing that can absorb and manage the drainage effectively.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6199, healthcare providers need to document the following:

• Date of service
• Length of the alginate or fiber gelling dressing used
• Medical necessity for using this specific dressing
• Any complications or adverse reactions related to the dressing

Providers should also ensure that the documentation supports the medical necessity of using a wound filler and the specific type of dressing used.

6. Historical Information and Code Maintenance

HCPCS code A6199 was added to the Healthcare Common Procedure Coding System on January 01, 1997. It has an effective date of January 01, 2009. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code A6199 is subject to pricing floors and ceilings, as indicated by the pricing indicator code 35. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. Medicare and other insurance providers may cover the cost of alginate or other fiber gelling dressings when used as wound fillers, subject to their specific coverage policies and guidelines.

8. Examples

Here are five examples of when HCPCS code A6199 should be billed:

1. A patient with a deep, exudating wound on their lower leg requires the use of alginate dressing as a wound filler.
2. A post-operative surgical wound with moderate drainage requires the use of fiber gelling dressing to promote healing.
3. A patient with a chronic pressure ulcer requires the use of alginate dressing as a wound filler to manage exudate.
4. An individual with a diabetic foot ulcer needs the application of fiber gelling dressing to create a moist wound environment.
5. A patient with a surgical incision that is healing by secondary intention requires the use of alginate dressing as a wound filler.