Summary & Overview

HCPCS A6219: Sterile Gauze Pad with Adhesive Border, ≤16 sq in

HCPCS Level II code A6219 designates a sterile, non-impregnated gauze pad 16 square inches or less, with any size adhesive border, billed per dressing. This supply-level code is commonly used for routine wound care and minor dressing changes across a range of outpatient and home-based settings. Accurate coding for dressings like A6219 ensures proper supply tracking, inventory control, and claims processing for low-cost disposable wound care items.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how A6219 is classified, typical sites of service, and the clinical context for use. The publication also summarizes common modifiers and administrative considerations relevant to billing and claims adjudication.

The analysis provides practical benchmarks for how this type of supply-level HCPCS code is applied across outpatient clinics, emergency departments, wound care centers, and home health services, plus notes on documentation and billing workflow implications. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA6219HCPCS Level IIwound caredressingsmedical suppliesoutpatienthome healthbilling

Billing Code Overview

HCPCS Level II code A6219 represents a sterile, non-impregnated gauze pad that is 16 square inches or less and may include any size adhesive border, billed per dressing. The item is a single-use wound dressing intended for wound coverage and protection.

Service type: Dressing/Ancillary Supply

Typical site of service: Outpatient clinics, physician offices, emergency departments, wound care centers, and home health settings

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult or pediatric patient presenting to an outpatient clinic, urgent care, emergency department, or wound care center with a small superficial wound, incidental laceration after minor trauma, or post-procedure incision requiring a protective sterile dressing. The clinician (physician, advanced practice clinician, or wound care nurse) performs wound assessment, cleansing, and hemostasis as needed, then applies a single sterile non-impregnated gauze pad measuring 16 square inches or less with an adhesive border. Documentation includes wound size and location, indication for dressing (e.g., to protect, absorb exudate, secure hemostasis), who applied the dressing, and whether any additional supplies or procedures were performed. Typical workflow: triage and wound assessment → cleansing/irrigation → hemostasis (if required) → application of the A6219 sterile adhesive gauze dressing → patient instructions for dressing care and follow-up. Typical sites of service include outpatient clinics, urgent care centers, emergency departments, ambulatory surgical centers, and home health visits when dressing supplies are provided as part of wound management.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when additional work beyond usual is documented (uncommon for a single dressing but applicable if complex wound preparation was required).
`23`	Unusual anesthesia	Use when general or regional anesthesia is administered for an unrelated procedure during the same encounter (rare for simple dressing application).
`52`	Reduced services	Use when a service was partially reduced or not completed as originally intended.
`53`	Discontinued procedure	Use when the procedure was started but terminated due to extenuating circumstances.
`59`	Distinct procedural service	Data not available in the input.
`76`	Repeat procedure by same provider	Data not available in the input.
`78`	Unplanned return to the operating/procedure room	Use when a patient must return to procedure room for a complication requiring re-intervention (rare for dressing alone).
`80`	Assistant surgeon	Use when an assistant surgeon is documented and billed (unlikely for simple dressing application).
`82`	Assistant surgeon (when qualified resident not available)	Use when an assistant is required and no resident is available.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use if an advanced practitioner provided assisting services when billable.
`NU`	New equipment	Use when items are new or first supplied (application depends on payer policy for supplies).
`QK`	Medical direction of two, three, or four qualified individuals	Use when the provider is directing multiple simultaneous procedures (rare for dressing supply).
`QX`	Modifier to identify services performed by certified surgical assistant	Use to indicate certified assistant when applicable.

Taxonomy Code	Specialty	Notes
`163W00000X`	Emergency Medicine Physician	Common provider in ED applying or ordering dressings.
`207Q00000X`	Family Medicine Physician	Outpatient or urgent care providers who apply dressings.
`207L00000X`	Internal Medicine Physician	Clinic-based wound care and post-procedure dressing.
`367500000X`	Nurse Practitioner	Frequently applies dressings and documents supply use.
`363L00000X`	Registered Nurse	Performs dressing application and wound care in many settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S01.01XA`	Laceration without foreign body of scalp, initial encounter	Small scalp lacerations commonly receive a sterile adhesive gauze dressing after repair or for protection.
`S31.000A`	Open wound of unspecified site of abdomen, initial encounter	Small abdominal superficial wounds or post-procedure incision sites may be dressed with `A6219`.
`S81.811A`	Laceration without foreign body of right lower leg, initial encounter	Extremity lacerations often require a small adhesive gauze dressing after cleaning and closure.
`Laceration, unspecified`	Data not available in the input.	Data not available in the input.
`Z48.02`	Encounter for removal of sutures and staples	Follow-up visits for suture removal often include application of a small sterile dressing if needed.
`T81.4XXA`	Infection following a procedure, initial encounter	Minor post-procedure wound infections may require dressing changes using adhesive sterile gauze.
`S61.201A`	Laceration without foreign body of right hand, initial encounter	Small hand lacerations frequently receive a sterile adhesive gauze dressing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12001`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.5 cm or less	Often performed immediately before application of a sterile adhesive gauze dressing for superficial lacerations.
`97597`	Debridement (e.g., high-pressure waterjet, sharp debridement) open wound, first 20 sq cm or less	May be performed prior to application of dressing for non-viable tissue removal and wound bed preparation.
`11042`	Debridement, muscle and/or fascia (first 20 sq cm)	Performed for deeper infected wounds prior to dressing; more extensive than superficial debridement.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedure	Used to bill for additional non-standard supplies provided with wound care; payers vary on accepting supply codes alongside `A6219`.
`99506`	Home visits for assistance with dressing changes supplies and education (nursing visits)	Represents skilled nursing visits that may apply or change `A6219` dressings in home health settings.