HCPCS Code A6207

Official Description

Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing

Short Descr	Contact layer >16<= 48 sq in
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
A2	Dressing for two wounds
GW	Service not related to the hospice patient's terminal condition
A3	Dressing for three wounds
A4	Dressing for four wounds
KX	Requirements specified in the medical policy have been met
A5	Dressing for five wounds
A7	Dressing for seven wounds
A6	Dressing for six wounds
A9	Dressing for nine or more wounds
A8	Dressing for eight 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
RT	Right side (used to identify procedures performed on the right side of the body)
GL	Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
EY	No physician or other licensed health care provider order for this item or service
GA	Waiver of liability statement issued as required by payer policy, individual case
GZ	Item or service expected to be denied as not reasonable and necessary
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
LT	Left side (used to identify procedures performed on the left side of the body)
79	Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
CR	Catastrophe/disaster related