How To Use HCPCS Code A6219

HCPCS code A6219 describes a specific type of gauze dressing that is non-impregnated, sterile, and has a pad size of 16 square inches or less. This dressing is equipped with an adhesive border of any size. In this article, we will explore the various aspects of HCPCS code A6219, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A6219?

HCPCS code A6219 is used to identify a gauze dressing that is non-impregnated, sterile, and has a pad size of 16 square inches or less. It is equipped with an adhesive border of any size. This code is specifically used for surgical dressings and falls under the category of medical supplies.

2. Official Description

The official description of HCPCS code A6219 is “Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing.” The short description for this code is “Gauze <= 16 sq in w/border."

3. Procedure

1. Start by preparing the necessary materials, including the gauze dressing, adhesive border, and any additional supplies required for the dressing change.
2. Ensure that the gauze dressing is non-impregnated and sterile.
3. Measure the size of the wound or area that requires dressing.
4. Select a gauze pad with a size of 16 square inches or less.
5. Apply the adhesive border around the edges of the gauze pad.
6. Ensure that the dressing is securely attached to the wound or area being treated.
7. Document the procedure and any relevant information in the patient’s medical record.

4. When to use HCPCS code A6219

HCPCS code A6219 should be used when providing gauze dressing with a pad size of 16 square inches or less and an adhesive border. This code is applicable for surgical dressings and is used to bill for the specific supplies used in the dressing change procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6219, healthcare providers need to ensure that they document the use of the specific gauze dressing with the pad size and adhesive border. The documentation should include the date of service, the patient’s medical record number, the size of the dressing, and any other relevant information. The billing should be done according to the guidelines provided by the payer, ensuring that all necessary information is included in the claim.

6. Historical Information and Code Maintenance

HCPCS code A6219 was added to the Healthcare Common Procedure Coding System on January 01, 1997. It has an effective date of January 01, 2009. No maintenance actions have been 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 A6219 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 35, which indicates that it falls under the category of surgical dressings and is subject to price floors and ceilings. The multiple pricing indicator code for A6219 is A, which means it is not applicable as HCPCS priced under one methodology. Providers should follow the reimbursement guidelines provided by Medicare or other insurance carriers when billing for this code.

8. Examples

Here are five examples of when HCPCS code A6219 should be billed:

1. A patient with a small surgical wound requiring a gauze dressing with an adhesive border.
2. A post-operative patient with a dressing size of 12 square inches and an adhesive border.
3. A patient with a chronic wound requiring regular dressing changes using gauze pads of 16 square inches or less with adhesive borders.
4. A patient with a skin tear that needs a non-impregnated gauze dressing with a pad size of 10 square inches and an adhesive border.
5. A patient with a pressure ulcer requiring a gauze dressing with a pad size of 14 square inches and an adhesive border.