K0746 HCPCS Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

HCPCS K0746: Absorptive Wound Dressing for Home NPWT, Pad >48 sq in

HCPCS Level II code K0746 designates an absorptive wound dressing intended for use with a home-model, portable suction pump, with a pad size greater than 48 square inches. The code captures a wound care accessory used in negative pressure wound therapy (NPWT) delivered in the home setting. Nationally, accurate coding of NPWT supplies like K0746 affects coverage determinations, durable medical equipment payment processes, and clinical supply planning for home health providers and suppliers.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical role, typical site-of-service implications, and the payer landscape affecting coverage and reimbursement for home NPWT supplies. The publication also summarizes common billing considerations, relevant modifiers and system interactions where provided, and highlights areas where input data was not available.

This report is intended for billing managers, home health clinicians, and policy analysts who need a clear, national-level reference for coding and payer engagement related to large-pad absorptive dressings used with portable home suction pumps.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0746HCPCS Level IInegative pressure wound therapyhome healthdurable medical equipmentwound dressingabsorbent dressingmedical supplies

Billing Code Overview

HCPCS Level II code K0746 describes an absorptive wound dressing for use with a suction pump, home model, portable, with a pad size greater than 48 square inches. This product is a durable medical equipment dressing intended to interface with negative pressure wound therapy (NPWT) systems for use in the home setting.

Service Type: Durable medical equipment; wound care accessory for negative pressure wound therapy

Typical Site of Service: Home health care / Patient residence

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a chronic or complex wound (for example, a large sacral pressure ulcer, postoperative abdominal wound with high exudate, or diabetic foot ulcer) being managed at home with negative pressure wound therapy (NPWT) using a portable/home suction pump. The clinician (wound care nurse or home health provider) assesses the wound in the outpatient clinic or during a home visit, measures wound size (greater than 48 square inches for the pad), documents wound characteristics and prior treatments, and determines that an absorptive wound dressing compatible with a portable suction pump is required. The device is supplied as part of home-based NPWT; training is provided to the patient or caregiver on pump operation, dressing changes, skin protection, and signs of complications. Billing uses HCPCS Level II code K0746 for the absorptive dressing (pad size >48 sq in). Typical sites of service include the patient’s residence (home health), outpatient wound clinic, or skilled nursing facility when the portable/home NPWT system is used.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to apply or adapt the dressing is substantially greater than typical (document rationale).

Related Codes

HCPCS-K0073-CASTER-PIN-LOCK

HCPCS K0073: Caster Pin Lock, Each

HCPCS-K0014-POWER-WHEELCHAIR-BASE

HCPCS K0014: Other Motorized/Power Wheelchair Base

HCPCS-K0868-POWER-WHEELCHAIR-GROUP-4-300-LB-CAPACITY

HCPCS K0868: Power Wheelchair Group 4, 300 lb Capacity

HCPCS-K0019-ARM-PAD-REPLACEMENT

HCPCS K0019: Arm Pad, Replacement Only, Each

HCPCS-K0098-DRIVE-BELT-POWER-WHEELCHAIR-REPLACEMENT

HCPCS K0098: Drive Belt for Power Wheelchair, Replacement Only

HCPCS-K0011-POWER-WHEELCHAIR-PROGRAMMABLE-CONTROLS-TREMOR-DAMPENING

HCPCS K0011: Power Wheelchair with Programmable Controls

HCPCS-K0886-POWER-WHEELCHAIR-GROUP-4-HEAVY-DUTY-301-450-LBS

HCPCS K0886: Power Wheelchair, Group 4 Heavy Duty, 301–450 lb Capacity

HCPCS-K0808-POWER-OPERATED-VEHICLE-VERY-HEAVY-DUTY-451-600-LB

HCPCS K0808: Power Operated Vehicle, Very Heavy Duty (451–600 lb)

HCPCS-K0744-ABSORPTIVE-WOUND-DRESSING-HOME-PORTABLE-PAD-16SQIN-OR-LESS

HCPCS K0744: Absorptive Wound Dressing for Home Suction Pump

HCPCS-K0008-CUSTOM-MANUAL-WHEELCHAIR

HCPCS Level II K0008: Custom Manual Wheelchair/Base

Showing 1–10 of 135

52

Taxonomy Code	Specialty	Notes
207Q00000X	Physical Therapist	Wound care-specialized physical therapists may assist with NPWT patient education and mobility planning.
207L00000X	Occupational Therapist	Provides training on activities of daily living and dressing changes for patients with large wounds.
363A00000X	Home Health Agency	Agency clinicians (nurses) provide in-home dressing changes and supply management.
207P00000X	Physician Assistant	Frequently performs wound assessments and applies NPWT dressings under physician oversight.
207R00000X	Nurse Practitioner	Common provider for wound clinics and home health coordination for NPWT supply and management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.153`	Pressure ulcer of sacral region, stage 3	Large sacral pressure ulcers commonly require NPWT with large absorptive pads (>48 sq in).
`L97.413`	Non-pressure chronic ulcer of right calf with fat layer exposed	Chronic lower-extremity ulcers with heavy exudate may need NPWT and large dressings.
`L97.524`	Non-pressure chronic ulcer of left heel with necrosis of bone	Deep, exudative foot ulcers often require advanced dressings and NPWT supply.
`K63.89`	Other specified diseases of intestine	Postoperative abdominal wounds with enteric fistula or high-output wound drainage may necessitate large NPWT dressings.
`E11.621`	Type 2 diabetes mellitus with foot ulcer	Diabetic foot ulcers with significant drainage are common indications for NPWT and large absorptive pads.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97605`	Debridement, open wound, non-selective (eg, wet-to-moist dressings, enzymatic, abrasion), first 20 sq cm or less	May be performed prior to NPWT dressing placement for wound bed preparation (smaller debridement services).
`97606`	Debridement, open wound, non-selective, each additional 20 sq cm (list separately in addition to code for primary service)	Used for larger wounds when additional debridement area is required before applying NPWT dressings.
`97607`	Application of a topical wound dressing, negative pressure wound therapy (e.g., vacuum-assisted drainage), including provision of device(s), suction pump, and dressings; first 48 sq in	Related to NPWT services; `K0746` specifically bills the larger pad (>48 sq in) supply while `97607` covers first 48 sq in NPWT application.
`97608`	Application of a topical wound dressing, negative pressure wound therapy; each additional 48 sq in (list separately in addition to code for primary service)	Used when NPWT application exceeds the first 48 sq in; pairs clinically with larger dressings such as the pad represented by `K0746`.
`11042`	Debridement, subcutaneous tissue (includes epidermis and dermis), first 20 sq cm or less	Surgical debridement codes that may be documented when operative debridement precedes NPWT supply application.