Summary & Overview
HCPCS A6404: Large Sterile Gauze Pad, Non‑Adhesive
HCPCS Level II code A6404 represents a sterile, non-impregnated gauze pad larger than 48 square inches without an adhesive border, billed per dressing. This supply code matters nationally because it captures utilization and billing for large absorbent dressings used across acute and ambulatory care settings, influencing supply-chain costs, outpatient wound-care reimbursements, and standardization of dressing reporting.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how A6404 is categorized and used clinically, typical sites of service where it is billed, and the common modifiers associated with supply and procedural reporting. The publication outlines benchmarks for coding practice, common payer coverage considerations, and operational implications for billing large sterile dressings. It also highlights policy and documentation areas that affect claim adjudication for wound-care supplies.
This summary serves clinicians, coding specialists, revenue cycle managers, and policy analysts who need a national-level reference for classification, clinical context, and payer coverage patterns related to large sterile gauze dressings billed under HCPCS Level II code A6404. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A6404 describes a sterile, non-impregnated gauze pad with a pad size greater than 48 square inches, without an adhesive border, billed per dressing. This item is used as a primary or secondary wound dressing for large wound sites or surgical dressings where a substantial absorbent surface is required.
Service type: Dressing supply / wound care material
Typical site of service: Hospital inpatient and outpatient settings, ambulatory surgical centers, emergency departments, and outpatient clinics where large sterile dressings are applied.
Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient wound care clinic or emergency department with a large surgical or traumatic wound requiring a primary dressing. The clinician selects a sterile, non-impregnated gauze pad larger than 48 square inches (for example, 8" x 6" or similar) to achieve adequate coverage of the wound bed and peri-wound area. Typical indications include postoperative incision sites with moderate exudate, large superficial traumatic abrasions, donor/recipient sites after skin grafting, or wounds after debridement where a single large sterile dressing is preferred to multiple smaller pads. The clinical workflow includes wound assessment, cleansing, possible hemostasis, measurement and documentation of wound size and exudate, application of topical agents if indicated, placement of the A6404 sterile gauze pad, securing with secondary dressings or adhesive/securement as needed, and documentation of dressing type, size, quantity, and clinical rationale in the medical record. Billing uses the HCPCS Level II code A6404 reported per dressing applied; if multiple identical dressings are supplied at the same encounter, units are reported accordingly. Typical sites of service are outpatient wound care centers, ambulatory surgical centers, physician offices, urgent care centers, and hospital inpatient or emergency departments when large sterile gauze pads are used during treatment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |