HCPCS Range Other Dressings, Coverings, and Wound Treatment Supplies

• 1 Skin sealants, protectants, moisturizers, ointments, any type, any size ( A6250 )

• 2 Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ( A6251 )

• 3 Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ( A6252 )

• 4 Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ( A6253 )

• 5 Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ( A6254 )

• 6 Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ( A6255 )

• 7 Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing ( A6256 )

• 8 Transparent film, sterile, 16 sq. in. or less, each dressing ( A6257 )

• 9 Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ( A6258 )

• 10 Transparent film, sterile, more than 48 sq. in., each dressing ( A6259 )

• 11 Wound cleansers, any type, any size ( A6260 )

• 12 Wound filler, gel/paste, per fluid ounce, not otherwise specified ( A6261 )

• 13 Wound filler, dry form, per gram, not otherwise specified ( A6262 )

• 14 Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard ( A6266 )

• 15 Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ( A6402 )

• 16 Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing ( A6403 )

• 17 Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ( A6404 )

• 18 Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard ( A6407 )

• 19 Eye pad, sterile, each ( A6410 )

• 20 Eye pad, non-sterile, each ( A6411 )

• 21 Eye patch, occlusive, each ( A6412 )