Revised August 2011 HCPCS. Coding. Bandages
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1 Coding Information 3M Health Care Products Revised August 2011 Ostomy Products Professional Skin Care Products Dressings and Bandages Medical Tapes Rehabilitationn 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 A4369 Skin barrier, liquid A5120 Skin barrier, wipes A4369 Skin barrier, liquid A4369 Skin barrier, liquid Professional Skin Care Products 3M Cavilon 3-in-1 Incontinence Care Lotion A6250 Skin sealants, protectants, 3M Cavilon Antifungal Cream A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, 3M Cavilon Durable Barrier Cream A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, 3M Cavilon Durable Barrier Cream Fragrance Free A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, NOTE: Please see Disclaimer information on page one. 1
4 Professional Skin Care Products (continued) 3M Cavilon Extra Dry Skin Cream A6250 Skin sealants, protectants, 3M Cavilon Moisturizing Body Cream A6250 Skin sealants, protectants, 3M Cavilon Moisturizing Hand Lotion 9205 A6250 Skin sealants, protectants, 9215 A6250 Skin sealants, protectants, 3M Cavilon No-Rinse Skin Cleanser A6260 Wound cleansers, any type, any size 3M Cavilon No Sting Barrier Film A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, A6250 Skin sealants, protectants, NOTE: Please see Disclaimer information on page one. 2
5 Dressings and Bandages 3M Coban Self-Adherent Wrap* A6453 Self-adherent bandage, elastic, 1581B (Blue) A6453 Self-adherent bandage, elastic, A6453 Self-adherent bandage, elastic, 1582B (Blue) A6453 Self-adherent bandage, elastic, 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, 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, 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* Retail Packages: H A6453 Self-adherent bandage, elastic, H A6453 Self-adherent bandage, elastic, H 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 A6453 Self-adherent bandage, elastic, A6453 Self-adherent bandage, elastic, 2082C (Brights) A6453 Self-adherent bandage, elastic, A6454 Self-adherent bandage, elastic, 2083C (Brights) A6454 Self-adherent bandage, elastic, 2083S (Sterile) A6454 Self-adherent bandage, elastic, A6454 Self-adherent bandage, elastic, 2084L A6454 Self-adherent bandage, elastic, 2084S (Sterile) A6454 Self-adherent bandage, elastic, 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 Roll #1 A6454 Self-adherent bandage, elastic, Roll #2 A6454 Self-adherent bandage, elastic, 3M Coban 2 Layer Lite Compression System Roll #1 A6454 Self-adherent bandage, elastic, Roll #2 A6454 Self-adherent bandage, elastic, 3M Medipore +Pad Soft Cloth Adhesive Wound Dressing A6219 Gauze, nonimpregnated, with border A6219 Gauze, nonimpregnated, with border A6219 Gauze, nonimpregnated, with border A6219 Gauze, nonimpregnated, with border A6219 Gauze, nonimpregnated, with border A6219 Gauze, nonimpregnated, with border A6219 Gauze, nonimpregnated, with border A6220 Gauze, nonimpregnated, with border 3M Tegaderm Absorbent Clear Acrylic Dressing 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 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 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 IV Securement Dressing A6257 Transparent film A6257 Transparent film A6258 Transparent film A6257 Transparent film 3M Tegaderm Diamond Pattern Film Dressing A6258 Transparent film A6257 Transparent film A6258 Transparent film 3M Tegaderm Foam Dressing (nonadhesive) 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 High Gelling Alginate Dressing A6196 Alginate dressing, wound cover A6199 Alginate dressing, wound filler 3M Tegaderm High Integrity Alginate Dressing 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 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 HP Transparent Film Dressing Frame Style 9519HP A6257 Transparent film 9534HP A6257 Transparent film 9536HP A6258 Transparent film 9543HP A6258 Transparent film 9545HP (oval) A6257 Transparent film 9546HP (oval) A6258 Transparent film 9548HP (oval) A6258 Transparent film 3M Tegaderm Hydrocolloid Dressing Ovals: A6237 Hydrocolloid dressing A6238 Hydrocolloid dressing A6238 Hydrocolloid dressing Sacral: A6238 Hydrocolloid dressing Squares: A6234 Hydrocolloid dressing A6235 Hydrocolloid dressing 3M Tegaderm Hydrocolloid Thin Dressing Ovals: A6237 Hydrocolloid dressing A6238 Hydrocolloid dressing A6238 Hydrocolloid dressing Squares: A6234 Hydrocolloid dressing 3M Tegaderm Hydrogel Wound Filler A6248 Hydrogel dressing, wound filler A6248 Hydrogel dressing, wound filler NOTE: Please see Disclaimer information on page one. 7
10 Dressings and Bandages (continued) 3M Tegaderm IV Advanced Securement Dressing A6257 Transparent film A6257 Transparent film A6258 Transparent film 3M Tegaderm IV Securement Dressing 9525HP A6257 Transparent film 3M Tegaderm IV Transparent Film Dressing with Border A6257 Transparent film A6257 Transparent film A6257 Transparent film A6258 Transparent film A6257 Transparent film 3M Tegaderm Matrix Dressing with PHI Technology A6231 Gauze, impregnated with hydrogel A6232 Gauze, impregnated with hydrogel 3M Tegaderm Non-Adherent Contact Layer A6206 Contact layer A6207 Contact layer A6208 Contact layer 3M Tegaderm +Pad Film Dressing with Non-Adherent Pad A6203 Composite dressing A6203 Composite dressing A6203 Composite dressing 3587 (oval) A6203 Composite dressing A6203 Composite dressing A6203 Composite dressing A6203 Composite dressing A6203 Composite dressing A6204 Composite dressing NOTE: Please see Disclaimer information on page one. 8
11 Dressings and Bandages (continued) 3M Tegaderm Plus Transparent Dressing (with Iodophor) A6257 Transparent film A6258 Transparent film 3M Tegaderm Transparent Film Dressing A6257 Transparent film A6258 Transparent film A6257 Transparent film A6258 Transparent film 1622W A6257 Transparent film 1624W A6257 Transparent film A6258 Transparent film 1626W A6258 Transparent film A6258 Transparent film A6258 Transparent film A6259 Transparent film A6258 Transparent film A6257 Transparent film Small Quantity Packages: 9505W A6257 Transparent film 9506W A6258 Transparent film Retail Packages: H A6257 Transparent film H A6258 Transparent film 3M Tegaderm Transparent Film Roll A6257-A6259 Transparent film A6257-A6259 Transparent film A6257-A6259 Transparent film 3M Wound Cleanser A6260 Wound cleansers, any type, any size NOTE: Please see Disclaimer information on page one. 9
12 Medical Tapes 3M Blenderm Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof 3M Cloth Adhesive Tape A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof 3M Durapore Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Single Use: 1538S A4452 Tape, waterproof 1538S A4452 Tape, waterproof 3M Kind Removal Silicone Tape A4452 Tape, waterproof A4452 Tape, waterproof Short Rolls: 2770S A4452 Tape, waterproof 2770S A4452 Tape, waterproof 3M Medipore Dress-It Pre-Cut Dressing Covers A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof NOTE: Please see Disclaimer information on page one. 10
13 Medical Tapes (continued) 3M Medipore H Soft Cloth Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Short Rolls: 2862S A4452 Tape, waterproof 2864S A4452 Tape, waterproof 2866S A4452 Tape, waterproof 3M Medipore Soft Cloth Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Short Rolls: 2962S A4452 Tape, waterproof 2964S A4452 Tape, waterproof 2966S A4452 Tape, waterproof 3M Microfoam Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof 3M Micropore Tape Standard: A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof A4450 Tape, non-waterproof Single Use: 1530S A4450 Tape, non-waterproof 1530S 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 NOTE: Please see Disclaimer information on page one. 11
14 Medical Tapes (continued) 3M Transpore Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof Single Use: 1527S A4452 Tape, waterproof 1527S A4452 Tape, waterproof 3M Transpore White Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof 3M Universal Cloth Adhesive Tape A4452 Tape, waterproof A4452 Tape, waterproof A4452 Tape, waterproof See page 13 for Medical Tapes Conversion to 18 Square Inch Units. Rehabilitation Products 3M Reston Self-Adhering Foam Pad Medium Support: 1560M E1399 DME, miscellaneous High Support: 1561H E1399 DME, miscellaneous 3M Reston Self-Adhering Foam Roll Light Support: 1563L E1399 DME, miscellaneous NOTE: Please see Disclaimer information on page one. 12
15 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. 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. 13
16 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 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. 14
17 3 Skin & Wound Care Division 3M Health Care 3M Center, Building 275-4W-02 St. Paul, MN USA M Canada P.O. Box 5757 London, Ontario N6A 4T1 Canada lthcare Please recycle. Printed in U.S.A. 3M 2005, All rights reserved (POD) 2/07.
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Revised February 2015 Coding Information 3M Health Care Products Ostomy Products Professional Skin Care Products Dressings and Bandages Medical Tapes Rehabilitation Products Disclaimer: The reimbursement
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