HCPCS Code Section: HCPCS A Codes

Transparent film, sterile, more than 48 sq. in., each dressing Short Description: Transparent film > 48 sq in Coverage Code: Special coverage instructions apply Action Code: No maintenance for …

Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard Short Description: Conform band n/s w>=3″

Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing Short Description: Transparent film >16

Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard Short Description: Conform band n/s w

Transparent film, sterile, 16 sq. in. or less, each dressing Short Description: Transparent film

Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard Short Description: Pad band w>=3″

Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing Short Description: Absorpt drg > 48 sq in w/bdr …

Adhesive bandage, first-aid type, any size, each Short Description: Adhesive bandage, first-aid Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: January 1, …

Eye patch, occlusive, each Short Description: Occlusive eye patch Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2003 Effective Date: January 1, …

Eye pad, non-sterile, each Short Description: Non-sterile eye pad Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 2003 Effective Date: …