Summary & Overview
HCPCS A6255: Specialty Absorptive Wound Dressing, 16–48 sq. in.
HCPCS Level II code A6255 identifies a sterile specialty absorptive wound dressing with a pad size greater than 16 square inches and up to 48 square inches, with any size adhesive border, billed per dressing. This supply code is used across a variety of outpatient and home-based wound-care settings for patients requiring larger absorptive dressings for moderate to heavily exudating wounds. Nationally, supplies such as those represented by A6255 are important drivers of wound-care episode costs and are relevant to clinicians, billing staff, and payers managing post-acute and chronic wound populations.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn how A6255 is described clinically and operationally, what settings commonly use this dressing, and where to find benchmark and policy context. The publication provides benchmarks for utilization and spend (where available), notes common billing practices, and summarizes policy considerations that affect coverage and claim adjudication for specialty absorptive dressings. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code A6255 describes a specialty absorptive dressing intended for wound coverage. The item is sterile and specified by pad size: more than 16 square inches but less than or equal to 48 square inches, and it may include any size adhesive border. The unit of service is each dressing.
Service Type: Wound care dressing application/supply
Typical Site of Service: Outpatient clinics, wound care centers, home health visits, and other ambulatory care settings where sterile wound dressings are applied or supplied.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a moderately exudative, non-actively infected lower extremity ulcer (for example, a venous stasis ulcer or a post-operative wound) requiring a specialty absorptive dressing. The dressing described by billing code A6255 (sterile specialty absorptive dressing, pad >16 sq in and ≤48 sq in, with any size adhesive border) is applied in an outpatient wound clinic, physician office, home health visit, or skilled nursing facility. Clinical workflow: wound assessment (size, depth, exudate, infection status), cleansing and debridement as indicated, selection of appropriate dressing size and type, application of A6255 to cover the wound bed with an adhesive border for securement, patient/caregiver instructions for wear time and change frequency, documentation of dressing characteristics and wound measurements, and scheduling follow-up for wound reassessment. This dressing is typically used when absorption capacity and a secure adhesive border are needed to manage moderate drainage and protect periwound skin.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | When no specific modifier applies and standard reporting is appropriate |