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    v1.0.28
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a6196-alginate-fiber-gelling-wound-dressing-16-sq-in
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    HCPCS Level II A6196: Alginate/Fiber-Gelling Wound Dressing, ≤16 sq in

    HCPCS Level II code A6196 describes a sterile alginate or other fiber-gelling wound dressing sold as a single pad 16 square inches or less; the service is wound care dressing supply typically used in outpatient wound care clinics, physician offices, home health, and other ambulatory settings for management of moderate to heavy exudating wounds where gel-forming absorptive materials are indicated.

    For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Bone Turnover Markers Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a partial-thickness lower extremity or sacral wound complicated by moderate-to-heavy exudate and slough. The clinician selects an alginate or other fiber gelling sterile dressing sized 16 sq. in. or less to provide high-absorbency coverage, maintain a moist wound environment, and facilitate autolytic debridement. The procedure occurs during an outpatient wound clinic visit, home health skilled nursing visit, or acute-care bedside dressing change. Workflow: assessment of wound size, depth, and exudate; cleansing and debridement as indicated; application of hemostatic or alginate dressing A6196 cut to size; secondary dressing application and securement; documentation of wound measurements, exudate, dressing applied, patient tolerance, and plan for re-evaluation or dressing change frequency.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97597Debridement; selective debridement, open wound, (e.g., sharps, scissors, forceps), including topical application(s), wound assessment, and instruction(s) for continued care, first 20 sq cm or lessMay be performed immediately before A6196 dressing placement when manual debridement of slough is required.
    97598Debridement; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)Billed in addition to 97597 when larger wound area requires further debridement prior to dressing application.
    11042Debridement, subcutaneous tissue (includes epidermis and dermis, when performed); first 20 sq cm or lessSurgical debridement that may precede application of A6196 in an operative or clinic setting.
    12002Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (2.5 cm or less)Minor wound closure procedures performed before or instead of dressing supply application in some workflows.
    99501Home visit for wound care and dressing change, each 15 minutesRepresents home health or skilled nursing visits where A6196 may be supplied and applied; codes vary by payer and region.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    261QM1300XMulti-Specialty Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    2083P0011XUndersea and Hyperbaric Medicine (Preventive Medicine) PhysicianA specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide…
    332BP3500XParenteral & Enteral Nutrition Supplies (DME)Suppliers · Durable Medical Equipment & Medical Supplies
    207N00000XDermatology PhysicianA dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
    376J00000XHomemakerAn individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly respo…

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    5 rows

    PolicyPayerEffective Date
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01
    Parathyroid Hormone, Phosphorus, Calcium, and Magnesium TestingOscar Health2026-10-01
    Testosterone — Coverage Criteria for Measurement and MonitoringOscar Health2026-10-01
    Thyroid Disease TestingOscar Health2026-10-01

    Related Codes

    HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

    HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

    HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

    HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

    HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

    HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

    HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

    HCPCS Level II A4210: Needle-free Injection Device, Each

    HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

    HCPCS Level II A4211: Supplies for Self-Administered Injections

    HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

    HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

    HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

    HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

    HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

    HCPCS Level II A4215: Needle, Sterile, Any Size

    HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

    HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

    Showing 1–10 of 633

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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