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    v1.0.28
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a6245-hydrogel-wound-dressing-16-sq-in-or-less
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    HCPCS Level II A6245: Hydrogel Wound Dressing, 16 sq. in. or Less

    HCPCS Level II code A6245 describes a sterile hydrogel wound dressing (wound cover) in a pad size of 16 square inches or less with any size adhesive border, billed per dressing; this represents a topical wound care dressing typically used for moist wound healing and minor to moderate exudative wounds and is commonly supplied in outpatient clinics, wound care centers, physician offices, and home health settings as a single-item durable medical supply for dressing changes or wound management.

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

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a superficial to partial-thickness wound such as a surgical incision with minimal drainage, a skin tear, a superficial burn, or an epithelializing chronic wound. The patient presents to an outpatient wound clinic, primary care office, ambulatory surgery center, or skilled nursing facility for wound assessment and dressing change. After wound cleaning and appropriate debridement if needed, the clinician selects a sterile hydrogel dressing to maintain a moist wound environment and facilitate autolytic debridement and epithelialization. The dressing described by A6245 (hydrogel dressing, pad size 16 sq. in. or less, with any size adhesive border) is applied to the wound bed, secured as indicated, and the clinician documents wound size, stage, exudate, presence of infection, and planned dressing change frequency in the medical record. Typical workflow steps include wound assessment, cleansing, measurement and photography as indicated, dressing selection and application, patient and caregiver education about dressing care and frequency, and scheduling follow-up or home health services if ongoing dressing changes are required.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97602Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (e.g., using sharp instruments), each 20 sq cm or lessFrequently performed prior to application of a hydrogel dressing when there is nonviable tissue requiring removal
    97597Debridement (e.g., high pressure water jet, sharp) other than described in 97602, first 20 sq cm or lessAlternate debridement code that may precede hydrogel dressing application for thicker necrotic tissue
    11042Debridement, subcutaneous tissue (includes epidermis and dermis), first 20 sq cm or lessSurgical debridement code that may be performed in the operating room before applying hydrogel dressings post-procedure
    99070Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or procedureUsed to report additional supplies when payers require separate billing for dressings and related materials alongside evaluation and management services
    97535Self-care/home management training (e.g., dressing change instruction), each 15 minutesUsed to bill professional time to train patients or caregivers in home application and care of hydrogel dressings

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    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…
    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…
    2085R0204XVascular & Interventional Radiology PhysicianA radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tom…
    103TW0100XDeactivated - Psychotherapy Women
    2084P2900XPain Medicine (Psychiatry & Neurology) PhysicianA neurologist, child neurologists or psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experie…
    2083X0100XOccupational Medicine PhysicianOccupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environm…
    2471S1302XSonography Radiologic TechnologistA radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    B95.61Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere
    E10.621Type 1 diabetes mellitus with foot ulcer
    E11.621Type 2 diabetes mellitus with foot ulcer
    I83.10Varicose veins of unspecified lower extremity with inflammation
    I83.219Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation
    L03.115Cellulitis of right lower limb
    L03.116Cellulitis of left lower limb
    L08.9Local infection of the skin and subcutaneous tissue, unspecified
    L89.023Pressure ulcer of left elbow, stage 3

    Showing 1–10 of 26

    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

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    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.
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