Question 1

What is HCPCS code A6404?

Accepted Answer

HCPCS code A6404 is "Sterile gauze > 48 sq in". Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing

Question 2

What category is A6404 in?

Accepted Answer

A6404 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A6404?

Accepted Answer

Use A6404 when billing for sterile gauze > 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 A6404 covered by Medicare?

Accepted Answer

Coverage for A6404 (Sterile gauze > 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 A6404?

Accepted Answer

Documentation for A6404 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).