Q: What category is A6197 in?

A6197 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Q: When should I use HCPCS code A6197?

Use A6197 when billing for alginate drsg >16 <=48 sq in. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Q: Is A6197 covered by Medicare?

Coverage for A6197 (Alginate drsg >16 <=48 sq in) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Q: What documentation is required for A6197?

Documentation for A6197 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).

Question 1

What is HCPCS code A6197?

Accepted Answer

HCPCS code A6197 is "Alginate drsg >16 <=48 sq in". Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing

Question 2

What category is A6197 in?

Accepted Answer

A6197 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A6197?

Accepted Answer

Use A6197 when billing for alginate drsg >16 <=48 sq in. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is A6197 covered by Medicare?

Accepted Answer

Coverage for A6197 (Alginate drsg >16 <=48 sq in) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for A6197?

Accepted Answer

Documentation for A6197 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).