A6214 Foam Dressing HCPCS — Reimbursement & Policy

HCPCS Level II code A6214 designates a sterile foam wound dressing with a pad larger than 48 square inches and any size adhesive border. This supply code is used for managing moderate-to-large wounds that require a sterile, absorbent dressing with an adhesive border, and it matters nationally because wound-care supplies are a frequent component of post-acute and outpatient care for chronic wounds, surgical sites, and pressure injuries. Coverage and coding of large adhesive foam dressings affect clinical workflows, supply costs, and payment for home health and outpatient wound-care services.

Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical purpose, typical sites of service, and payer coverage context. The publication summarizes expected benchmarks and common modifiers used with this type of supply (where available), highlights clinical scenarios in which a large sterile foam dressing is applied, and outlines areas for billing attention such as accurate description of dressing size and adhesive border characteristics. Data not available in the input will be noted where necessary. The material is intended for billers, coding specialists, supply chain managers, and clinicians involved in wound management and reimbursement processes.

Billing Code Overview

HCPCS Level II code A6214 describes a sterile foam wound dressing intended as a wound cover. The full description is: Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing.

Service type: Wound care dressing application / supply.

Typical site of service: Outpatient wound care clinics, ambulatory surgical centers, home health visits, and other outpatient or non-acute care settings where large sterile foam dressings are applied.

Data not available in the input.

Clinical Context

A typical patient is a 68-year-old with a large stage IV pressure ulcer on the sacrum following prolonged immobility after hospitalization for stroke. The wound bed is irregular with moderate exudate and requires a large, conformable sterile foam dressing with an adhesive border to protect the wound, absorb fluid, and maintain a moist healing environment. A home health nurse or outpatient wound care nurse evaluates the wound, measures the area (>48 square inches), selects dressing A6214, cleanses the wound per protocol, applies the foam dressing, documents size and exudate, and provides caregiver instructions for dressing changes at prescribed intervals. The dressing may be replaced in clinic, home health visits, or emergency department visits for wound care, and may be billed per dressing applied.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no applicable modifier is required for the service.
`11`	Primary procedure	Use when this dressing application is the primary service during the encounter.

Taxonomy Code	Specialty	Notes
`163WH0000X`	Wound Care Specialist	Clinicians focused on advanced wound management and dressing selection.
`207Q00000X`	Registered Nurse	Nurses providing outpatient or home health wound dressing application and patient education.
`2080P0207X`	General Surgery	Surgeons performing debridement and surgical wound management requiring large foam dressings.
`282N00000X`	Physical Medicine & Rehabilitation	Clinicians coordinating pressure offloading and wound care in immobile patients.
`363L00000X`	Home Health Agency	Organizational taxonomy for agencies providing wound care and dressing applications in the home.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.153`	Pressure ulcer of sacral region, stage 3	Large stage 3 pressure ulcers commonly require large foam dressings for protection and absorption.
`L89.154`	Pressure ulcer of sacral region, stage 4	Deep ulcers with extensive tissue loss often need large sterile foam dressings and frequent dressing changes.
`L97.322`	Non-pressure chronic ulcer of left calf limited to breakdown of skin	Chronic lower-extremity ulcers with moderate exudate benefit from large absorptive foam dressings.
`I83.013`	Varicose veins of bilateral lower extremities with ulcer and inflammation, right leg	Venous stasis ulcers with drainage commonly require large foam dressings with adhesive borders.
`E11.621`	Type 2 diabetes mellitus with foot ulcer	Diabetic foot ulcers that are large or exudative may be managed with large sterile foam dressings as part of wound care.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97605`	Negative pressure wound therapy, short-term, total wound(s) surface <50 cm2; debridement, not applicable (short application)	May be used before or after dressing application when topical advanced therapies are applied; smaller NPWT adjunct.
`97606`	Negative pressure wound therapy, short-term, total wound(s) surface >=50 cm2	Used when large wounds require NPWT and dressing management in conjunction with large foam dressings.
`11042`	Debridement, subcutaneous tissue, first 20 sq cm or less	Performed prior to placement of definitive foam dressing to remove necrotic tissue.
`97597`	Debridement (e.g., high-pressure irrigation) open wound(s), first 20 sq cm or less; selective debridement non-selective	Used during wound care encounters preceding dressing application for removal of slough and biofilm.
`99000`	Handling and/or conveyance of specimen for transfer from facility to laboratory (when applicable)	Occasionally reported when tissue samples are taken during wound care prior to dressing placement.

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Summary & Overview

HCPCS A6214: Foam Dressing, Sterile, Pad >48 sq. in., Adhesive Border