HCPCS Code A6199

Official Description

Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches

Short Descr	Alginate drsg wound filler
Coverage	Special coverage instructions apply
Pricing Indicator(s)	35 – Supplies And Surgical Dressings - Surgical dressings (price subject to floors and ceilings)
MPI	A – Not applicable, as HCPCS priced under one methodology
MCM	2079
BETOS	D1A – Medical/surgical supplies
TOS Code(s)	S – Surgical dressings or other medical supplies
Added Date	1/1/1997
Status Code	Bundled/Excluded Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Packaged into APC Rates
MUE	0
MUE	Not applicable/unspecified.
IOM	100-02, 15, 100
OTS Orthotic	No
CCS Clinical Classification	243 - DME and supplies

A1	Dressing for one wound
A9	Dressing for nine or more wounds
A2	Dressing for two wounds
GW	Service not related to the hospice patient's terminal condition
GL	Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
A3	Dressing for three wounds
GZ	Item or service expected to be denied as not reasonable and necessary
KX	Requirements specified in the medical policy have been met
A4	Dressing for four wounds
A5	Dressing for five wounds
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
EY	No physician or other licensed health care provider order for this item or service
A7	Dressing for seven wounds
SD	Services provided by registered nurse with specialized, highly technical home infusion training
GA	Waiver of liability statement issued as required by payer policy, individual case
58	Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
95	Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AW	Item furnished in conjunction with a surgical dressing
LT	Left side (used to identify procedures performed on the left side of the body)
RT	Right side (used to identify procedures performed on the right side of the body)