Non-sterile gauze dressing, pad size 16 square inches or less, without adhesive

Description

This product is a non-sterile gauze dressing designed for wound care, measuring 16 square inches or less. It does not have an adhesive border, making it suitable for various applications where adhesive is not required.

Medicare Hospital Outpatient Reimbursement (OPPS)

OPPS Payment Rate

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Patient Copayment / Coinsurance

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Top Modifiers

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HCPCS/CPT A1Primary or secondary dressing for one wound(32.36%)

HCPCS/CPT KXDocumentation requirements met for DMEPOS items(13.97%)

HCPCS/CPT A2Dressing modifier for two wounds(13.92%)

HCPCS/CPT A3Dressing modifier for three wounds(8.18%)

HCPCS/CPT GWService unrelated to hospice patient's terminal condition(6.91%)

HCPCS/CPT GYItem or service excluded from Medicare benefits(6.54%)

HCPCS/CPT A4Dressing modifier for four wounds(4.99%)

HCPCS/CPT GAWaiver of liability statement issued per payer policy(4.14%)

HCPCS/CPT A5Dressing modifier for five wounds(3.24%)

HCPCS/CPT GZItem or service expected to be denied as not reasonable and necessary(2.44%)

Code Crosswalks

No crosswalks found.

Alternate Codes

No alternates found.

Billed With Codes

No codes found here.

Sources

We make no claims to ownership of the coding systems referenced on this platform. Codes and descriptions are produced from claims and chargemaster data available through the CMS-9915-F Transparency in Coverage Final Rule and via state or federal datasets. This service is provided solely as a reference to encourage use of these codes in our chargemaster review and automated billing tools, so that healthcare professionals can understand and correctly report these codes in their claims.

Federal and State Datasets

List of CPT/HCPCS Codes, Centers for Medicare & Medicaid Services (CMS)
HCPCS Quarterly Update, Centers for Medicare & Medicaid Services (CMS)
Physician Fee Schedule Relative Value Files, Centers for Medicare & Medicaid Services (CMS)
OPPS Addendum B, Centers for Medicare & Medicaid Services (CMS)
ASC Payment Addenda, Centers for Medicare & Medicaid Services (CMS)