HCPCS Coding Information 3M Health Care Products
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1 Revised February 2015 Coding Information 3M Health Care Products Ostomy Products Professional Skin Care Products Dressings and Bandages Medical Tapes Rehabilitation Products
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3 Disclaimer: The reimbursement information provided by 3M Health Care and its representatives is intended to provide general information relevant to coding for 3M products. Insurers reimbursement policies can vary, however, and the use of the codes discussed here does not guarantee that an insurer will cover or pay at any particular level. Ostomy Products 3M Cavilon No Sting Barrier Film Catalog No. Code Generic Category 3343 A4369 Skin barrier, liquid 3344 A5120 Skin barrier, wipes 3345 A4369 Skin barrier, liquid 3346 A4369 Skin barrier, liquid Professional Skin Care Products 3M Cavilon 3-in-1 Incontinence Care Lotion Catalog No. Code Generic Category 3383 A6250 Skin sealants, protectants, 3M Cavilon Antifungal Cream Catalog No. Code Generic Category 3389 A6250 Skin sealants, protectants, 3390 A6250 Skin sealants, protectants, 3M Cavilon Durable Barrier Cream Fragrance Free Catalog No. Code Generic Category 3353 A6250 Skin sealants, protectants, 3354 A6250 Skin sealants, protectants, 3355 A6250 Skin sealants, protectants, 3M Cavilon Extra Dry Skin Cream Catalog No. Code Generic Category 9205 A6250 Skin sealants, protectants, 9215 A6250 Skin sealants, protectants, NOTE: Please see Disclaimer information on page one. 1
4 Professional Skin Care Products (continued) 3M Cavilon Moisturizing Hand Lotion Catalog No. Code Generic Category 9205 A6250 Skin sealants, protectants, 9215 A6250 Skin sealants, protectants, 3M Cavilon No-Rinse Skin Cleanser Catalog No. Code Generic Category 3380 A6260 Wound cleansers, any type, any size 3M Cavilon No Sting Barrier Film Catalog No. Code Generic Category 3343 A6250 Skin sealants, protectants, 3344 A6250 Skin sealants, protectants, 3345 A6250 Skin sealants, protectants, 3346 A6250 Skin sealants, protectants, NOTE: Please see Disclaimer information on page one. 2
5 Dressings and Bandages 3M Coban Self-Adherent Wrap* Catalog No. Code Generic Category 1581 A6453 Self-adherent bandage, elastic, 1581B (Blue) A6453 Self-adherent bandage, elastic, 1582 A6453 Self-adherent bandage, elastic, 1582B (Blue) A6453 Self-adherent bandage, elastic, 1583 A6454 Self-adherent bandage, elastic, 1583A (Rainbow Pack) A6454 Self-adherent bandage, elastic, 1583B (Blue) A6454 Self-adherent bandage, elastic, 1583G (Green) A6454 Self-adherent bandage, elastic, 1583N (Neon Pack) A6454 Self-adherent bandage, elastic, 1583R (Red) A6454 Self-adherent bandage, elastic, 1583S (Sterile) A6454 Self-adherent bandage, elastic, 1583W (White) A6454 Self-adherent bandage, elastic, 1583Y (Yellow) A6454 Self-adherent bandage, elastic, 1584 A6454 Self-adherent bandage, elastic, 1584B (Blue) A6454 Self-adherent bandage, elastic, 1584L A6454 Self-adherent bandage, elastic, 1584S (Sterile) A6454 Self-adherent bandage, elastic, 1586 A6455 Self-adherent bandage, elastic, width greater than or equal to five inches 1586S (Sterile) A6455 Self-adherent bandage, elastic, width greater than or equal to five inches *Caution: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions. NOTE: Please see Disclaimer information on page one. 3
6 Dressings and Bandages (continued) 3M Nexcare Coban Self-Adherent Wrap* Catalog No. Code Generic Category Retail Packages: H1581 A6453 Self-adherent bandage, elastic, H1582 A6453 Self-adherent bandage, elastic, H1583 A6454 Self-adherent bandage, elastic, *Caution: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions. 3M Coban LF (Latex Free) Self-Adherent Wrap with Hand Tear Catalog No. Code Generic Category 2081 A6453 Self-adherent bandage, elastic, 2081C (Brights) A6453 Self-adherent bandage, elastic, A6453 Self-adherent bandage, elastic 20815C (Brights) A6453 Self-adherent bandage, elastic, 2082 A6453 Self-adherent bandage, elastic, 2082C (Brights) A6453 Self-adherent bandage, elastic, 2082S (Sterile) A6453 Self-adherent bandage, elastic, 2083 A6454 Self-adherent bandage, elastic, 2083C (Brights) A6454 Self-adherent bandage, elastic, 2083S (Sterile) A6454 Self-adherent bandage, elastic, 2084 A6454 Self-adherent bandage, elastic, 2084C (Brights) A6454 Self-adherent bandage, elastic, 2084L A6454 Self-adherent bandage, elastic, 2084S (Sterile) A6454 Self-adherent bandage, elastic, 2086 A6455 Self-adherent bandage, elastic, width greater than or equal to five inches 2086S (Sterile) A6455 Self-adherent bandage, elastic, width greater than or equal to five inches NOTE: Please see Disclaimer information on page one. 4
7 Dressings and Bandages (continued) 3M Coban 2 Layer Compression System Catalog No. Code Generic Category 2094 Roll #1 A6441 Padding bandage, width greater than or equal to Roll #2 A6452 three High compression bandage, width greater than or equal to three 3M Coban 2 Layer Lite Compression System Catalog No. Code Generic Category 2794 Roll #1 A6441 Padding bandage, width greater than or equal to Roll #2 A6452 three High compression bandage, width greater than or equal to three 3M Medipore +Pad Soft Cloth Adhesive Wound Dressing Catalog No. Code Generic Category 3562 A6219 Gauze, nonimpregnated, with border 3564 A6219 Gauze, nonimpregnated, with border 3566 A6219 Gauze, nonimpregnated, with border 3568 A6219 Gauze, nonimpregnated, with border 3569 A6219 Gauze, nonimpregnated, with border 3570 A6219 Gauze, nonimpregnated, with border 3571 A6219 Gauze, nonimpregnated, with border 3573 A6220 Gauze, nonimpregnated, with border 3M Tegaderm Absorbent Clear Acrylic Dressing Catalog No. Code Generic Category Ovals: A6203 Composite dressing A6203 Composite dressing A6203 Composite dressing Sacral: A6204 Composite dressing Squares: A6203 Composite dressing A6204 Composite dressing 3M Tegaderm Ag Mesh Dressing with Silver Catalog No. Code Generic Category A6402 Gauze, nonimpregnated, without border A6403 Gauze, nonimpregnated, without border A6403 Gauze, nonimpregnated, without border A6404 Gauze, nonimpregnated, without border NOTE: Please see Disclaimer information on page one. 5
8 Dressings and Bandages (continued) 3M Tegaderm Alginate Ag Silver Dressing Catalog No. Code Generic Category A6196 Alginate dressing, wound cover A6197 Alginate dressing, wound cover A6198 Alginate dressing, wound cover A6199 Alginate dressing, wound filler 3M Tegaderm CHG Chlorhexidine Gluconate I.V. Port Dressing Catalog No. Code Generic Category 1665 A6258 Transparent film 3M Tegaderm CHG Chlorhexidine Gluconate I.V. Securement Dressing Catalog No. Code Generic Category 1657 A6257 Transparent film 1658 A6257 Transparent film 1659 A6258 Transparent film 1660 A6257 Transparent film 3M Tegaderm Diamond Pattern Film Dressing Catalog No. Code Generic Category 1679 A6257 Transparent film 1684 A6257 Transparent film 1686 A6258 Transparent film 3M Tegaderm High Gelling Alginate Dressing Catalog No. Code Generic Category A6196 Alginate dressing, wound cover A6199 Alginate dressing, wound filler 3M Tegaderm High Integrity Alginate Dressing Catalog No. Code Generic Category A6196 Alginate dressing, wound cover A6199 Alginate dressing, wound filler NOTE: Please see Disclaimer information on page one. 6
9 Dressings and Bandages (continued) 3M Tegaderm High Performance Foam Adhesive Dressing Catalog No. Code Generic Category A6212 Foam dressing, wound cover A6212 Foam dressing, wound cover A6212 Foam dressing, wound cover A6212 Foam dressing, wound cover A6212 Foam dressing, wound cover A6212 Foam dressing, wound cover A6213 Foam dressing, wound cover Heel/elbow design: A6212 Foam dressing, wound cover 3M Tegaderm High Performance Foam Non-Adhesive Dressing Catalog No. Code Generic Category A6209 Foam dressing, wound cover A6209 Foam dressing, wound cover A6210 Foam dressing, wound cover A6211 Foam dressing, wound cover A6209 Foam dressing, wound cover A6211 Foam dressing, wound cover 3M Tegaderm HP Transparent Film Dressing Frame Style Catalog No. Code Generic Category 9519HP A6257 Transparent film 9534HP A6257 Transparent film 9536HP A6258 Transparent film 9543HP A6258 Transparent film 9545HP (oval) A6257 Transparent film 9546HP (oval) A6257 Transparent film 9548HP (oval) A6258 Transparent film 3M Tegaderm Hydrocolloid Dressing Catalog No. Code Generic Category Ovals: A6237 Hydrocolloid dressing A6237 Hydrocolloid dressing A6238 Hydrocolloid dressing Sacral: A6238 Hydrocolloid dressing Squares: A6234 Hydrocolloid dressing A6235 Hydrocolloid dressing NOTE: Please see Disclaimer information on page one. 7
10 Dressings and Bandages (continued) 3M Tegaderm Hydrocolloid Thin Dressing Catalog No. Code Generic Category Ovals: A6237 Hydrocolloid dressing A6237 Hydrocolloid dressing A6238 Hydrocolloid dressing Squares: A6234 Hydrocolloid dressing 3M Tegaderm Hydrogel Wound Filler Catalog No. Code Generic Category A6248 Hydrogel dressing, wound filler A6248 Hydrogel dressing, wound filler 3M Tegaderm I.V. Advanced Securement Dressing Catalog No. Code Generic Category 1680 A6257 Transparent film 1682 A6257 Transparent film 1683 A6257 Transparent film 1685 A6257 Transparent film 1688 A6258 Transparent film 1689 A6258 Transparent film 3M Tegaderm I.V. Securement Dressing Catalog No. Code Generic Category 9525HP A6257 Transparent film 3M Tegaderm I.V. Transparent Film Dressing with Adhesive-Free Window Catalog No. Code Generic Category 1668 A6258 Transparent film 3M Tegaderm I.V. Transparent Film Dressing with Border Catalog No. Code Generic Category 1610 A6257 Transparent film 1633 A6257 Transparent film 1635 A6257 Transparent film 1650 A6258 Transparent film 1655 A6257 Transparent film NOTE: Please see Disclaimer information on page one. 8
11 Dressings and Bandages (continued) 3M Tegaderm Non-Adherent Contact Layer Catalog No. Code Generic Category 5642 A6206 Contact layer 5643 A6207 Contact layer 5644 A6208 Contact layer 3M Tegaderm +Pad Film Dressing with Non-Adherent Pad Catalog No. Code Generic Category 3582 A6203 Composite dressing 3584 A6203 Composite dressing 3586 A6203 Composite dressing 3587 (oval) A6203 Composite dressing 3588 A6203 Composite dressing 3589 A6203 Composite dressing 3590 A6203 Composite dressing 3591 A6203 Composite dressing 3593 A6204 Composite dressing 3M Tegaderm Silicone Foam Border Dressing Catalog No. Code Generic Category A6212 Foam dressing, wound cover A6212 Foam dressing, wound cover A6213 Foam dressing, wound cover 3M Tegaderm Superabsorber Dressing Catalog No. Code Generic Category A6196 Alginate dressing, wound cover A6197 Alginate dressing, wound cover A6197 Alginate dressing, wound cover A6198 Alginate dressing, wound cover NOTE: Please see Disclaimer information on page one. 9
12 Dressings and Bandages (continued) 3M Tegaderm Transparent Film Dressing Catalog No. Code Generic Category 1614 A6257 Transparent film 1616 A6258 Transparent film 1620 A6257 Transparent film 1621 A6258 Transparent film 1622W A6257 Transparent film 1624W A6257 Transparent film 1626 A6258 Transparent film 1626W A6258 Transparent film 1627 A6258 Transparent film 1628 A6258 Transparent film 1629 A6259 Transparent film 1630 A6258 Transparent film 1634 A6257 Transparent film Small Quantity Packages: 9505W A6257 Transparent film 9506W A6258 Transparent film Retail Packages H1624 A6257 Transparent film H1626 A6258 Transparent film 3M Tegaderm Transparent Film Roll Catalog No. Code Generic Category A6257-A6259 Transparent film A6257-A6259 Transparent film A6257-A6259 Transparent film 3M Wound Cleanser Catalog No. Code Generic Category A6260 Wound cleansers, any type, any size NOTE: Please see Disclaimer information on page one. 10
13 Medical Tapes 3M Blenderm Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof 3M Cloth Adhesive Tape Catalog No. Code Generic Category A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof 3M Durapore Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Single Use: 1538S-1 A4452 Tape, waterproof 1538S-2 A4452 Tape, waterproof 3M Kind Removal Silicone Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Short Rolls: 2770S-1 A4452 Tape, waterproof 2770S-2 A4452 Tape, waterproof 3M Medipore Dress-It Pre-Cut Dressing Covers Catalog No. Code Generic Category 2954 A4452 Tape, waterproof 2955 A4452 Tape, waterproof 2956 A4452 Tape, waterproof 2957 A4452 Tape, waterproof 2958 A4452 Tape, waterproof NOTE: Please see Disclaimer information on page one. 11
14 Medical Tapes (continued) 3M Medipore H Soft Cloth Tape Catalog No. Code Generic Category 2861 A4452 Tape, waterproof 2862 A4452 Tape, waterproof 2863 A4452 Tape, waterproof 2864 A4452 Tape, waterproof 2866 A4452 Tape, waterproof 2868 A4452 Tape, waterproof Short Rolls: 2862S A4452 Tape, waterproof 2864S A4452 Tape, waterproof 2866S A4452 Tape, waterproof 3M Medipore Soft Cloth Tape Catalog No. Code Generic Category 2961 A4452 Tape, waterproof 2962 A4452 Tape, waterproof 2963 A4452 Tape, waterproof 2964 A4452 Tape, waterproof 2966 A4452 Tape, waterproof 2968 A4452 Tape, waterproof Short Rolls: 2962S A4452 Tape, waterproof 2964S A4452 Tape, waterproof 2966S A4452 Tape, waterproof 3M Microfoam Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof NOTE: Please see Disclaimer information on page one. 12
15 Medical Tapes (continued) 3M Micropore Tape Catalog No. Code Generic Category Standard: A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof Single Use 1530S-1 A4450 Tape, non-waterproof 1530S-2 A4450 Tape, non-waterproof Tan: A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof Dispenser Pack: A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof 3M Transpore Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Single Use: 1527S-1 A4452 Tape, waterproof 1527S-2 A4452 Tape, waterproof 3M Transpore White Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof 1527S-2 A4452 Tape, waterproof Single Use 1534S-1 A4452 Tape, waterproof 1534S-2 A4452 Tape, waterproof 3M Universal Cloth Adhesive Tape Catalog No. Code Generic Category A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof See page 15 for Medical Tapes Conversion to 18 Square Inch Units. NOTE: Please see Disclaimer information on page one. 13
16 Rehabilitation Products 3M Reston Self-Adhering Foam Pad Catalog No. Code Generic Category Medium Support: 1560M E1399 DME, miscellaneous High Support: 1561H E1399 DME, miscellaneous 3M Reston Self-Adhering Foam Roll Catalog No. Code Generic Category Light Support: 1563L E1399 DME, miscellaneous NOTE: Please see Disclaimer information on page one. 14
17 Medical Tapes Conversion to 18 Square Inch Units 3M Medical Tapes Catalog No. Size No. of 18 Sq. Inch Units 3M Blenderm Tape ½ in. x 5 yd in. x 5 yd in. x 5 yd. 20 3M Cloth Adhesive Tape ½ in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 60 3M Durapore Tape ½ in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 60 Single Use Rolls: 1538S-1 1 in. x 1-1/2 yd S-2 2 in. x 1-1/2 yd. 6 3M Kind Removal Silicone Tape in. x 5.5 yd in. x 5.5 yd in. x 5.5 yd in. x 5.5 yd in. x 5.5 yd. 22 Single Use Rolls: 2770S-1 1 in. x 1.5 yd S-2 2 in. x 1.5 yd. 6 3M Medipore H Soft Cloth Tape in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 160 Two Yard Rolls: 2862S 2 in. x 2 yd S 4 in. x 2 yd S 6 in. x 2 yd. 24 3M Medipore Soft Cloth Tape in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 160 Two Yard Rolls: 2962S 2 in. x 2 yd S 4 in. x 2 yd S 6 in. x 2 yd. 24 3M Microfoam Tape in. x 5-1/2 yd in. x 5-1/2 yd in. x 5-1/2 yd in. x 5-1/2 yd. 44 NOTE: Please see Disclaimer information on page one. 15
18 Medical Tapes Conversion to 18 Square Inch Units (continued) 3M Micropore Tape Standard: ½ in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 60 Single Use Rolls: 1530S-1 1 in. x 1-1/2 yd S-2 2 in. x 1-1/2 yd. 6 Tan: ½ in. x 10 yd in. x 10 yd in. x 10 yd. 40 Dispenser Pack: /2 in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 60 3M Transpore Tape ½ in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 60 Single Use Rolls: 1527S-1 1 in. x 1-1/2 yd S-2 2 in. x 1-1/2 yd. 6 3M Transpore White Tape /2 in. x 10 yd in. x 10 yd in. x 10 yd in. x 10 yd. 60 Single Use Rolls: 1534S-1 1 in. x 1-1/2 yd S-2 2 in. x 1-1/2 yd. 6 3M Universal Cloth Adhesive Tape in. x 10 yd in. x 10 yd in. x 10 yd. 60 Note: This chart does not recommend how or how much of a particular medical tape should be billed to Medicare or other health care insurers. All billing of products to the patient s health insurance program should accurately reflect the actual product and amount that was clinically necessary to treat the patient s condition and the amount actually provided to the patient. NOTE: Please see Disclaimer information on page one. 16
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20 Critical & Chronic Care Solutions Division 3M Health Care 2510 Conway Avenue St. Paul, MN USA M, Blenderm, Cavilon, Coban, Durapore, Medipore, Microfoam, Micropore, Nexcare, Reston, Tegaderm and Transpore are trademarks of 3M Company. Please recycle. Printed in USA. 3M 2004, All rights reserved
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