How To Use HCPCS Code A6258

HCPCS code A6258 describes a transparent film dressing that is sterile and covers an area greater than 16 square inches but less than or equal to 48 square inches. This dressing is used in medical procedures to protect wounds and promote healing. In this article, we will explore the details of HCPCS code A6258, 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 A6258?

HCPCS code A6258 is used to identify a specific type of transparent film dressing. This dressing is sterile and is designed to cover wounds or surgical sites. It is larger than 16 square inches but does not exceed 48 square inches in size. The purpose of this dressing is to provide a protective barrier while allowing for visualization of the wound or surgical site.

2. Official Description

The official description of HCPCS code A6258 is “Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing.” The short description for this code is “Transparent film >16<=48 in." These descriptions accurately define the specific characteristics and size range of the dressing.

3. Procedure

1. Prepare the wound or surgical site by cleaning and disinfecting it according to standard medical practices.
2. Ensure that the transparent film dressing is sterile and free from any damage or contamination.
3. Carefully remove the backing from the dressing, taking care not to touch the adhesive side.
4. Position the dressing over the wound or surgical site, ensuring that it covers the entire area.
5. Smooth out any wrinkles or air bubbles to ensure proper adhesion.
6. Press down firmly on the dressing to secure it in place.
7. Document the application of the transparent film dressing in the patient’s medical record.

4. When to use HCPCS code A6258

HCPCS code A6258 should be used when a healthcare provider applies a transparent film dressing that meets the specified size criteria. This dressing is typically used for wounds or surgical sites that require protection and visualization. It is important to note that this code should only be used when the dressing size falls within the range of more than 16 square inches but less than or equal to 48 square inches.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6258, healthcare providers should ensure that the following documentation requirements are met:

• Medical record documentation should clearly indicate the need for the transparent film dressing and the size of the dressing applied.
• The date of service and the duration of the dressing application should be documented.
• Any complications or additional procedures related to the dressing application should be documented.

6. Historical Information and Code Maintenance

HCPCS code A6258 was added to the Healthcare Common Procedure Coding System on January 01, 1997. It has an effective date of January 01, 2009. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code A6258 is classified under the pricing indicator code 35, which indicates that it falls under the category of surgical dressings. The pricing for this code is subject to floors and ceilings, meaning that there are specific reimbursement limits set by Medicare or other insurance providers. The multiple pricing indicator code A indicates that this code is not applicable for multiple pricing methodologies.

8. Examples

Here are five examples of when HCPCS code A6258 should be billed:

1. A patient undergoes a surgical procedure that requires a transparent film dressing to be applied to the incision site. The dressing used measures 20 square inches.
2. A wound care clinic applies a sterile transparent film dressing to a patient’s large abrasion, which measures 30 square inches.
3. A post-operative patient requires a transparent film dressing to be applied to a surgical site that measures 25 square inches.
4. A burn unit applies a sterile transparent film dressing to a patient’s burn area, which measures 40 square inches.
5. A home healthcare nurse applies a transparent film dressing to a patient’s surgical wound, which measures 18 square inches.