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 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
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
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
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, 20815 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
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: 90800 A6203 Composite dressing 90801 A6203 Composite dressing 90803 A6203 Composite dressing Sacral: 90807 A6204 Composite dressing Squares: 90802 A6203 Composite dressing 90805 A6204 Composite dressing 3M Tegaderm Ag Mesh Dressing with Silver Catalog No. Code Generic Category 90500 A6402 Gauze, nonimpregnated, without border 90501 A6403 Gauze, nonimpregnated, without border 90502 A6403 Gauze, nonimpregnated, without border 90503 A6404 Gauze, nonimpregnated, without border NOTE: Please see Disclaimer information on page one. 5
Dressings and Bandages (continued) 3M Tegaderm Alginate Ag Silver Dressing Catalog No. Code Generic Category 90301 A6196 Alginate dressing, wound cover 90303 A6197 Alginate dressing, wound cover 90305 A6198 Alginate dressing, wound cover 90307 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 90212 A6196 Alginate dressing, wound cover 90220 A6199 Alginate dressing, wound filler 3M Tegaderm High Integrity Alginate Dressing Catalog No. Code Generic Category 90112 A6196 Alginate dressing, wound cover 90120 A6199 Alginate dressing, wound filler NOTE: Please see Disclaimer information on page one. 6
Dressings and Bandages (continued) 3M Tegaderm High Performance Foam Adhesive Dressing Catalog No. Code Generic Category 90610 A6212 Foam dressing, wound cover 90611 A6212 Foam dressing, wound cover 90612 A6212 Foam dressing, wound cover 90613 A6212 Foam dressing, wound cover 90614 A6212 Foam dressing, wound cover 90615 A6212 Foam dressing, wound cover 90616 A6213 Foam dressing, wound cover Heel/elbow design: 90619 A6212 Foam dressing, wound cover 3M Tegaderm High Performance Foam Non-Adhesive Dressing Catalog No. Code Generic Category 90600 A6209 Foam dressing, wound cover 90601 A6209 Foam dressing, wound cover 90602 A6210 Foam dressing, wound cover 90603 A6211 Foam dressing, wound cover 90604 A6209 Foam dressing, wound cover 90605 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: 90001 A6237 Hydrocolloid dressing 90003 A6237 Hydrocolloid dressing 90004 A6238 Hydrocolloid dressing Sacral: 90007 A6238 Hydrocolloid dressing Squares: 90002 A6234 Hydrocolloid dressing 90005 A6235 Hydrocolloid dressing NOTE: Please see Disclaimer information on page one. 7
Dressings and Bandages (continued) 3M Tegaderm Hydrocolloid Thin Dressing Catalog No. Code Generic Category Ovals: 90021 A6237 Hydrocolloid dressing 90023 A6237 Hydrocolloid dressing 90024 A6238 Hydrocolloid dressing Squares: 90022 A6234 Hydrocolloid dressing 3M Tegaderm Hydrogel Wound Filler Catalog No. Code Generic Category 91110 A6248 Hydrogel dressing, wound filler 91111 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
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 90640 A6212 Foam dressing, wound cover 90641 A6212 Foam dressing, wound cover 90642 A6213 Foam dressing, wound cover 3M Tegaderm Superabsorber Dressing Catalog No. Code Generic Category 90701 A6196 Alginate dressing, wound cover 90702 A6197 Alginate dressing, wound cover 90703 A6197 Alginate dressing, wound cover 90704 A6198 Alginate dressing, wound cover NOTE: Please see Disclaimer information on page one. 9
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 16002 A6257-A6259 Transparent film 16004 A6257-A6259 Transparent film 16006 A6257-A6259 Transparent film 3M Wound Cleanser Catalog No. Code Generic Category 91101 A6260 Wound cleansers, any type, any size NOTE: Please see Disclaimer information on page one. 10
Medical Tapes 3M Blenderm Tape Catalog No. Code Generic Category 1525-0 A4452 Tape, waterproof 1525-1 A4452 Tape, waterproof 1525-2 A4452 Tape, waterproof 3M Cloth Adhesive Tape Catalog No. Code Generic Category 2950-0 A4450 Tape, non-waterproof 2950-1 A4450 Tape, non-waterproof 2950-2 A4450 Tape, non-waterproof 2950-3 A4450 Tape, non-waterproof 3M Durapore Tape Catalog No. Code Generic Category 1538-0 A4452 Tape, waterproof 1538-1 A4452 Tape, waterproof 1538-2 A4452 Tape, waterproof 1538-3 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 2770-1 A4452 Tape, waterproof 2770-2 A4452 Tape, waterproof 2775-0 A4452 Tape, waterproof 2775-1 A4452 Tape, waterproof 2775-2 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
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 1528-1 A4452 Tape, waterproof 1528-2 A4452 Tape, waterproof 1528-3 A4452 Tape, waterproof 1528-4 A4452 Tape, waterproof NOTE: Please see Disclaimer information on page one. 12
Medical Tapes (continued) 3M Micropore Tape Catalog No. Code Generic Category Standard: 1530-0 A4450 Tape, non-waterproof 1530-1 A4450 Tape, non-waterproof 1530-2 A4450 Tape, non-waterproof 1530-3 A4450 Tape, non-waterproof Single Use 1530S-1 A4450 Tape, non-waterproof 1530S-2 A4450 Tape, non-waterproof Tan: 1533-0 A4450 Tape, non-waterproof 1533-1 A4450 Tape, non-waterproof 1533-2 A4450 Tape, non-waterproof Dispenser Pack: 1535-0 A4450 Tape, non-waterproof 1535-1 A4450 Tape, non-waterproof 1535-2 A4450 Tape, non-waterproof 1535-3 A4450 Tape, non-waterproof 3M Transpore Tape Catalog No. Code Generic Category 1527-0 A4452 Tape, waterproof 1527-1 A4452 Tape, waterproof 1527-2 A4452 Tape, waterproof 1527-3 A4452 Tape, waterproof Single Use: 1527S-1 A4452 Tape, waterproof 1527S-2 A4452 Tape, waterproof 3M Transpore White Tape Catalog No. Code Generic Category 1534-0 A4452 Tape, waterproof 1534-1 A4452 Tape, waterproof 1534-2 A4452 Tape, waterproof 1534-3 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 881-1 A4452 Tape, waterproof 881-2 A4452 Tape, waterproof 881-3 A4452 Tape, waterproof See page 15 for Medical Tapes Conversion to 18 Square Inch Units. NOTE: Please see Disclaimer information on page one. 13
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
Medical Tapes Conversion to 18 Square Inch Units 3M Medical Tapes Catalog No. Size No. of 18 Sq. Inch Units 3M Blenderm Tape 1525-0 ½ in. x 5 yd. 5 1525-1 1 in. x 5 yd. 10 1525-2 2 in. x 5 yd. 20 3M Cloth Adhesive Tape 2950-0 ½ in. x 10 yd. 10 2950-1 1 in. x 10 yd. 20 2950-2 2 in. x 10 yd. 40 2950-3 3 in. x 10 yd. 60 3M Durapore Tape 1538-0 ½ in. x 10 yd. 10 1538-1 1 in. x 10 yd. 20 1538-2 2 in. x 10 yd. 40 1538-3 3 in. x 10 yd. 60 Single Use Rolls: 1538S-1 1 in. x 1-1/2 yd. 3 1538S-2 2 in. x 1-1/2 yd. 6 3M Kind Removal Silicone Tape 2770-1 1 in. x 5.5 yd. 11 2770-2 2 in. x 5.5 yd. 22 2775-0.75 in. x 5.5 yd. 22 2775-1 1 in. x 5.5 yd. 8 2775-2 2 in. x 5.5 yd. 22 Single Use Rolls: 2770S-1 1 in. x 1.5 yd. 3 2770S-2 2 in. x 1.5 yd. 6 3M Medipore H Soft Cloth Tape 2861 1 in. x 10 yd. 20 2862 2 in. x 10 yd. 40 2863 3 in. x 10 yd. 60 2864 4 in. x 10 yd. 80 2866 6 in. x 10 yd. 120 2868 8 in. x 10 yd. 160 Two Yard Rolls: 2862S 2 in. x 2 yd. 8 2864S 4 in. x 2 yd. 16 2866S 6 in. x 2 yd. 24 3M Medipore Soft Cloth Tape 2961 1 in. x 10 yd. 20 2962 2 in. x 10 yd. 40 2963 3 in. x 10 yd. 60 2964 4 in. x 10 yd. 80 2966 6 in. x 10 yd. 120 2968 8 in. x 10 yd. 160 Two Yard Rolls: 2962S 2 in. x 2 yd. 8 2964S 4 in. x 2 yd. 16 2966S 6 in. x 2 yd. 24 3M Microfoam Tape 1528-1 1 in. x 5-1/2 yd. 11 1528-2 2 in. x 5-1/2 yd. 22 1528-3 3 in. x 5-1/2 yd. 33 1528-4 4 in. x 5-1/2 yd. 44 NOTE: Please see Disclaimer information on page one. 15
Medical Tapes Conversion to 18 Square Inch Units (continued) 3M Micropore Tape Standard: 1530-0 ½ in. x 10 yd. 10 1530-1 1 in. x 10 yd. 20 1530-2 2 in. x 10 yd. 40 1530-3 3 in. x 10 yd. 60 Single Use Rolls: 1530S-1 1 in. x 1-1/2 yd. 3 1530S-2 2 in. x 1-1/2 yd. 6 Tan: 1533-0 ½ in. x 10 yd. 10 1533-1 1 in. x 10 yd. 20 1533-2 2 in. x 10 yd. 40 Dispenser Pack: 1535-0 1/2 in. x 10 yd. 10 1535-1 1 in. x 10 yd. 20 1535-2 2 in. x 10 yd. 40 1535-3 3 in. x 10 yd. 60 3M Transpore Tape 1527-0 ½ in. x 10 yd. 10 1527-1 1 in. x 10 yd. 20 1527-2 2 in. x 10 yd. 40 1527-3 3 in. x 10 yd. 60 Single Use Rolls: 1527S-1 1 in. x 1-1/2 yd. 3 1527S-2 2 in. x 1-1/2 yd. 6 3M Transpore White Tape 1534-0 1/2 in. x 10 yd. 10 1534-1 1 in. x 10 yd. 20 1534-2 2 in. x 10 yd. 40 1534-3 3 in. x 10 yd. 60 Single Use Rolls: 1534S-1 1 in. x 1-1/2 yd. 3 1534S-2 2 in. x 1-1/2 yd. 6 3M Universal Cloth Adhesive Tape 881-1 1 in. x 10 yd. 20 881-2 2 in. x 10 yd. 40 881-3 3 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
Critical & Chronic Care Solutions Division 3M Health Care 2510 Conway Avenue St. Paul, MN 55144-1000 USA 1-800-228-3957 www.3m.com/healthcare 3M, Blenderm, Cavilon, Coban, Durapore, Medipore, Microfoam, Micropore, Nexcare, Reston, Tegaderm and Transpore are trademarks of 3M Company. Please recycle. Printed in USA. 3M 2004, 2015. All rights reserved. 70-2009-6368-7