How To Use HCPCS Code A6402

HCPCS code A6402 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 does not have an adhesive border and is used for various medical purposes. In this article, we will explore the details of HCPCS code A6402, 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 A6402?

HCPCS code A6402 is used to identify a specific type of sterile gauze dressing that is non-impregnated and has a pad size of 16 square inches or less. This dressing does not have an adhesive border. It is important to note that HCPCS codes are used for billing and reporting purposes in the healthcare industry. Each code represents a specific medical supply, service, or procedure. HCPCS code A6402 is specifically used to identify this particular type of gauze dressing.

2. Official Description

The official description of HCPCS code A6402 is “Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing.” This description accurately defines the characteristics and specifications of the gauze dressing that falls under this code. The short description of this code is “Sterile gauze <= 16 sq in."

3. Procedure

1. Open the packaging of the sterile gauze dressing.
2. Ensure that the dressing is non-impregnated and has a pad size of 16 square inches or less.
3. Prepare the area where the dressing will be applied by cleaning and disinfecting it, if necessary.
4. Place the sterile gauze dressing on the intended area, ensuring proper coverage.
5. Secure the dressing in place using appropriate medical tape or bandages, if needed.
6. Dispose of any used materials and properly clean and sanitize the surrounding area.

4. When to use HCPCS code A6402

HCPCS code A6402 should be used when a healthcare provider utilizes a non-impregnated, sterile gauze dressing with a pad size of 16 square inches or less. This code is applicable in various medical settings and can be used for different types of wounds or injuries that require the use of such a dressing. It is important to ensure that the dressing meets the specific criteria outlined in the code description before using this code for billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6402, healthcare providers need to ensure that proper documentation is maintained. This documentation should include details such as the patient’s medical condition, the reason for using the gauze dressing, the size of the dressing used, and any other relevant information. Additionally, providers should follow the billing guidelines set forth by the relevant insurance companies or Medicare to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A6402 was added to the Healthcare Common Procedure Coding System on January 01, 1997. It has an effective date of January 01, 2006. 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 to the code since its addition. It is important for medical coders and billers to stay updated on any changes or revisions to HCPCS codes to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

HCPCS code A6402 falls under the pricing indicator code 35, which indicates that it is classified as a surgical dressing. The pricing for this code is subject to floors and ceilings, meaning that there are specific payment limits set for this type of dressing. The multiple pricing indicator code A indicates that this code is not applicable as HCPCS priced under one methodology. Medicare and other insurance providers may have specific coverage policies for HCPCS code A6402, so it is important to verify coverage and reimbursement guidelines with the respective payers.

8. Examples

Here are five examples of when HCPCS code A6402 should be billed:

1. A patient with a small surgical wound requiring a sterile gauze dressing of 12 square inches.
2. A burn patient with multiple small burns on their arm, requiring individual sterile gauze dressings of 8 square inches each.
3. A post-operative patient with a small incision site that needs a non-impregnated sterile gauze dressing of 10 square inches.
4. A patient with a chronic wound that requires daily dressing changes using non-impregnated sterile gauze dressings of 16 square inches or less.
5. A patient with a skin tear that needs a non-impregnated sterile gauze dressing of 6 square inches.