HCPCS Code A6402

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
Short DescriptionSterile gauze <= 16 sq in
Year2026
Coverage CodeD = Special coverage instructions apply
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2006
Code Added DateJanuary 01, 1997
Pricing Indicator35 = Surgical dressings (price subject to floors and ceilings)
Type of ServiceL = ESRD supplies (eff 04/95) (renal supplier in the home before 04/95) S = Surgical dressings or other medical supplies (eff 04/95)