Q: What category is A6403 in?

A6403 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Q: When should I use HCPCS code A6403?

Use A6403 when billing for sterile gauze>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 A6403 covered by Medicare?

Coverage for A6403 (Sterile gauze>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 A6403?

Documentation for A6403 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 A6403?

Accepted Answer

HCPCS code A6403 is "Sterile gauze>16 <= 48 sq in". Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing

Question 2

What category is A6403 in?

Accepted Answer

A6403 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A6403?

Accepted Answer

Use A6403 when billing for sterile gauze>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 A6403 covered by Medicare?

Accepted Answer

Coverage for A6403 (Sterile gauze>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 A6403?

Accepted Answer

Documentation for A6403 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).