Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
Short Description: Gauze <= 16 sq in water/sal Coverage Code: Special coverage instructions apply
Action Code: No maintenance for this code
Date Added: January 1, 1997
Effective Date: January 1, 2009
Termination Date: