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A6404 - Sterile gauze > 48 sq in

Navigation: HCPCS Codes > Codes with Prefix: A6
Field Value
HCPCS Code: A6404
Long Description: Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
Short Description: Sterile gauze > 48 sq in
Pricing Indicator 1: 35 (Surgical dressings (price subject to floors and ceilings))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
MCM Reference Section Number 1: 2079
Statute Number:
Coverage Code: D (Special coverage instructions apply)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: D1A (Medical/surgical supplies)
Type of Service Code 1: S (Surgical dressings or other medical supplies (effective 04/95))
Anesthesia Base Unit Quality: 0
Code Added: 01-01-1997
Action Effective Date: 01-01-2003
Action Code: N (No maintenance for this code)