Reimbursement Overview

Dressing Exudate - LowExudate - MediumExudate - HighDressing ChangePer Month
Alginate or Other Gelling FiberOnce Daily30
16 sqin or lessA6196not indicatedindicatedindicatedOnce Daily30
> 16sqin < 48sqinA6197not indicatedindicatedindicatedOnce Daily30
>48sqinA6198not indicatedindicatedindicatedOnce Daily30
rope/ribbon (per 6" length)A6199not indicatedindicatedindicatedOnce Daily30
Collagen
16 sqin or lessA6021indicatedindicatednot indicatedOnce Daily30
> 16sqin < 48sqinA6022indicatedindicatednot indicatedOnce Daily30
>48sqinA6023indicatedindicatednot indicatedOnce Daily30
Powder (per gm)A6010indicatedindicatednot indicatedOnce Daily30
Foam Dressing Non-Bordered
16 sqin or lessA6209not indicatedindicatedindicated3 per week12
> 16sqin < 48sqinA6210not indicatedindicatedindicated3 per week12
>48sqinA6211not indicatedindicatedindicated3 per week12
Foam Dressing Bordered
16 sqin or lessA6212not indicatedindicatedindicated3 per week12
> 16sqin < 48sqinA6213not indicatedindicatedindicatednot reimbursed0
>48sqinA6214not indicatedindicatedindicated3 per week12
Hydrocolloid Non-Bordered
16 sqin or lessA6234indicatedindicatednot indicated3 per week12
> 16sqin < 48sqinA6235indicatedindicatednot indicated3 per week12
>48sqinA6236indicatedindicatednot indicated3 per week12
Hydrocolloid Bordered (Pad Size)
16 sqin or lessA6237indicatedindicatednot indicated3 per week12
> 16sqin < 48sqinA6238indicatedindicatednot indicated3 per week12
>48sqinA6239indicatedindicatednot indicated3 per week12
Specialty Absorptive Dressing Non-Bordered
16 sqin or lessA6251not indicatedindicatedindicatedOnce Daily30
> 16sqin < 48sqinA6252not indicatedindicatedindicatedOnce Daily30
>48sqinA6253not indicatedindicatedindicatedOnce Daily30
Specialty Absorptive Dressing Bordered (Pad Size)
16 sqin or lessA6254not indicatedindicatedindicated1 every 2 days15
> 16sqin < 48sqinA6255not indicatedindicatedindicated1 every 2 days15
>48sqinA6253not indicatedindicatedindicated1 every 2 days15
Medical Tape
Waterproof ( 1 unit =18sqin)A4452At Dressing Change
16 sqin or less2 Units2 Unitsn.a.
> 16sqin < 48sqin3 Units3 Unitsn.a.
>48sqin4 Units4 Unitsn.a.
Mattress Class II Alternating Low Air lossE0277indicatedindicatedindicated1 per 5 yrs.n.a.
NPWT KitA6550indicatedindicatedindicated1 every 2 days15
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