Summary & Overview
HCPCS A6223: Sterile Impregnated Gauze Pad, 16-48 sq in
HCPCS Level II code A6223 denotes a sterile gauze pad impregnated with a substance other than water, normal saline, or hydrogel, sized greater than 16 square inches but no larger than 48 square inches, supplied without an adhesive border. This code captures a commonly used large topical wound dressing in outpatient and home health wound-care settings. Nationally, accurate coding for impregnated dressings like A6223 matters for supply tracking, billing consistency, and clinical documentation of wound-management supplies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context and typical sites of service, a summary of payer coverage considerations, and pointers to related code groupings. The publication also highlights common billing modifiers associated with supply claims and notes where input was not available.
The sectioned content that follows provides benchmarks, coding guidance context, and policy and billing notes relevant to healthcare billing teams, clinical staff managing wound care supplies, and revenue cycle personnel responsible for outpatient and home health supply reimbursement.
Billing Code Overview
HCPCS Level II code A6223 describes a sterile gauze pad impregnated with a substance other than water, normal saline, or hydrogel. The pad size is more than 16 square inches but less than or equal to 48 square inches, and the item is supplied without an adhesive border. The service represented is the provision of a large sterile, impregnated wound dressing for topical wound care.
The service type is durable medical supply/wound care dressing used for management of wounds requiring impregnated sterile gauze. The typical site of service includes outpatient clinic wound care centers, home health settings, and other ambulatory care locations where dressings are applied or supplied to patients.
Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient wound care clinic or emergency department with a moderately sized surgical or traumatic wound requiring a sterile, medicated dressing. The wound measures approximately 20–30 square inches and requires a nonadherent, impregnated gauze to maintain a therapeutic moisture environment and deliver topical agents (e.g., antiseptic or antibiotic-impregnated dressing). A registered nurse or wound care specialist performs wound cleansing, debridement if indicated, and applies a sterile impregnated gauze pad sized more than 16 sq. in. but less than or equal to 48 sq. in. (billing using A6223) to the wound without an adhesive border. The dressing is secured with secondary bandaging (wrap or tape) and the patient receives verbalized wound-care instructions and follow-up for dressing changes.
Typical site of service includes outpatient wound care clinics, ambulatory surgery centers for post-procedure dressing changes, emergency departments for acute traumatic wounds, and skilled nursing facilities for longer-term wound management. The service is supplied as a single sterile dressing per unit billed; multiple units are billed when multiple separate dressings are applied during the visit.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Data not available in the input. |