Summary & Overview
HCPCS A6216: Gauze Pad, Non-Impregnated, Non-Sterile, ≤16 sq in
HCPCS Level II code A6216 represents a single non-impregnated, non-sterile gauze pad (16 square inches or less) supplied without an adhesive border, billed per dressing. This commonly used wound care supply is a routine item in ambulatory and home health wound management and matters nationally because it is widely utilized across outpatient clinics, physician practices, and home health agencies for basic dressing changes and minor wound care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of how A6216 is classified and used clinically, typical sites of service where the item is supplied, and the common payer landscape relevant to coverage and billing. The publication also summarizes benchmarking considerations and policy context that affect supply billing for simple wound dressings nationally.
This summary equips billing managers, revenue cycle professionals, and clinical staff with a clear description of the code, the clinical context for its use, and the range of payers typically involved. Data not available in the input is noted where applicable in subsequent sections.
Billing Code Overview
HCPCS Level II code A6216 describes a non-impregnated, non-sterile gauze pad measuring 16 square inches or less, provided without an adhesive border, billed per dressing. The service type is wound care supply / dressing material intended for topical wound management and basic wound dressing changes.
Typical sites of service for items described by A6216 include outpatient clinics, physician offices, home health settings, and other ambulatory care locations where simple dressings are applied or supplied for patient use.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an ambulatory clinic, urgent care, or emergency department with a minor superficial skin abrasion, small laceration after suture removal, or a low-exudate surgical incision requiring a simple dressing. The clinician (primary care physician, urgent care provider, or nurse) inspects the wound, performs basic cleansing with saline or mild antiseptic, applies hemostasis as needed, and places a single non-sterile, non-impregnated gauze pad sized 16 square inches or less (A6216) directly over the wound. The dressing is secured with tape or a secondary wrap. Typical workflow steps: triage and vital signs, wound assessment and documentation (location, size, contamination), cleansing and hemostasis, application of the A6216 dressing, patient instructions for wound care and dressing change frequency, and scheduling follow-up or return precautions. Typical sites of service include outpatient physician offices, urgent care centers, emergency departments, and home health visits for basic dressing supplies. Common patient scenarios include minor traumatic abrasions, postoperative day-of-discharge low-exudate incisions, superficial pressure area care, and routine wound dressing changes when a small sterile dressing is not required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) |