How To Use HCPCS Code A6207

HCPCS code A6207 describes a contact layer dressing that is sterile and covers an area greater than 16 square inches but less than or equal to 48 square inches. This code is used to identify and bill for the specific type of dressing used in medical procedures or wound care.

1. What is HCPCS A6207?

HCPCS code A6207 is used to identify a contact layer dressing that is sterile and covers an area greater than 16 square inches but less than or equal to 48 square inches. This code is specific to the type of dressing used and helps healthcare providers accurately document and bill for the service or supply provided.

2. Official Description

The official description for HCPCS code A6207 is “Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing.” The short description is “Contact layer >16<= 48 sq in." These descriptions provide a clear understanding of the size and purpose of the dressing.

3. Procedure

1. Prepare the patient and the wound area for dressing application.
2. Ensure that the contact layer dressing is sterile and appropriate for the size of the wound.
3. Cleanse the wound area and apply any necessary topical medications or treatments.
4. Place the contact layer dressing over the wound, ensuring that it covers the entire area.
5. Secure the dressing in place using appropriate medical tape or bandages.
6. Document the procedure and any relevant patient information in the medical record.

4. When to use HCPCS code A6207

HCPCS code A6207 should be used when a contact layer dressing is applied to a wound or surgical site that meets the size criteria of more than 16 square inches but less than or equal to 48 square inches. This code is not applicable for smaller or larger dressings, as there are specific codes for those sizes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6207, healthcare providers need to document the size of the dressing applied and the specific wound or surgical site it was used on. The medical record should also include any relevant information regarding the patient’s condition and the necessity of the dressing. Proper documentation ensures accurate billing and reimbursement for the service or supply provided.

6. Historical Information and Code Maintenance

HCPCS code A6207 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 A6207 is covered by Medicare and other insurance providers. The pricing indicator code 35 indicates that this code falls under the category of surgical dressings, and the pricing is subject to floors and ceilings. The multiple pricing indicator code A means that this code is not applicable as HCPCS priced under one methodology. Healthcare providers should follow the specific billing guidelines and requirements of Medicare or other insurance carriers to ensure proper reimbursement.

8. Examples

Here are five examples of when HCPCS code A6207 should be billed:

1. A patient undergoes a surgical procedure that requires a contact layer dressing to cover a wound measuring 20 square inches.
2. A healthcare provider applies a contact layer dressing to a burn wound measuring 30 square inches.
3. A patient with a chronic wound receives a contact layer dressing that covers an area of 25 square inches.
4. A surgical site requires a contact layer dressing measuring 40 square inches for proper wound care.
5. A healthcare provider applies a contact layer dressing to a traumatic wound measuring 18 square inches.