Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a6210-foam-wound-dressing-17-48-sq-in-sterile-no-adhesive
    Ask Trek AI about this page

    HCPCS A6210: Foam Wound Dressing, 16–48 sq in, No Adhesive

    HCPCS Level II code A6210 describes a sterile foam wound dressing pad larger than 16 square inches up to and including 48 square inches, without an adhesive border; this item is used as a wound cover for management of medium-to-large superficial or partial-thickness wounds and is typically supplied in outpatient clinics, wound care centers, home health, or inpatient settings where dressings are applied or changed as part of wound care services.

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

    Customize your policy alerts

    Sign up for hcpcs A6210 policy alerts

    Get alerted when payer policies referencing A6210 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with a chronic stage 3 pressure ulcer on the lateral lower leg presents to an outpatient wound care clinic for dressing changes. The wound measures 7 cm x 5 cm (35 sq. in.) with moderate exudate and no active bleeding. A licensed wound care nurse or certified medical assistant under clinician supervision removes the prior dressing, inspects the wound, irrigates with normal saline, applies topical antimicrobial as ordered, and places a sterile foam dressing sized >16 sq. in. and ≤48 sq. in. without an adhesive border (A6210). The dressing is documented with wound size, exudate level, pain score, and next change interval. Billing occurs per dressing applied. Typical sites of service include outpatient wound care clinics, physician office-based procedure rooms, home health visits, and skilled nursing facilities. Common clinical workflow steps: wound assessment, cleansing/debridement as indicated, application of appropriate secondary dressings or securement (e.g., bandage wrap or ostomy barrier for non-adhesive dressings), patient or caregiver education, and documentation for reimbursement and supply inventory.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97597Debridement, open wound, selective debridement by removing devitalized tissue (e.g., slough, necrosis), without anesthesia; first 20 sq cm or lessOften performed prior to application of a foam dressing when necrotic tissue is present.
    97598Each additional 20 sq cm, or part thereof, of selective debridement (list separately in addition to code for primary procedure)Used when debridement area exceeds initial unit and foam dressing applied afterward.
    11042Debridement, muscle and/or fascia (first 20 sq cm)Surgical debridement in the operative setting prior to advanced dressing application.
    99605Medication therapy management services by a pharmacist, initial 15 minutes (example supportive code)May be used when topical therapies are reviewed and coordinated with dressing changes.
    11730Avulsion of nail plate, partial or complete, simple; singlePerformed in some wound cases involving periungual necrosis before dressing application.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…

    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…
    106S00000XBehavior TechnicianThe behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst c…
    261QI0500XInfusion Therapy Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    310500000XMental Illness Intermediate Care FacilityA nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by menta…
    2279E0002XEmergency Care Registered Respiratory TherapistThe immediate availability of diagnostic and therapeutic cardiopulmonary services in the assessment and management of trauma victims, patients requiri…
    363LP0808XPsychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    163WD1100XPeritoneal Dialysis Registered NurseNursing Service Providers · Registered Nurse

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    A46Erysipelas
    E10.621Type 1 diabetes mellitus with foot ulcer
    E11.621Type 2 diabetes mellitus with foot ulcer
    E11.622Type 2 diabetes mellitus with other skin ulcer
    I70.213Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
    I83.10Varicose veins of unspecified lower extremity with inflammation
    I87.2Venous insufficiency (chronic) (peripheral)
    K80.20Calculus of gallbladder without cholecystitis without obstruction
    L03.90Cellulitis, unspecified
    L08.9Local infection of the skin and subcutaneous tissue, unspecified

    Showing 1–10 of 22

    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

    • More pages

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.