2025 HCPCS Code A6402

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing

TAGS: dressing adhesive

Short Description	Sterile gauze <= 16 sq in
HCPCS Action Code	N - No maintenance for this code
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Code Added Date	January 01, 1997
HCPCS Action Effective Date	January 01, 2006
HCPCS Pricing Indicator Code	35 - Surgical dressings (price subject to floors and ceilings)
HCPCS Type Of Service Code	L - ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Coverage Issues Manual Reference Section Number