HCPCS A6403 Code. Sterile gauze>16 <= 48 sq in

HCPCS Code: A6403
Long Description: Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing
Short Description: Sterile gauze>16 <= 48 sq in

Original information is taken from A6403 page

Pricing Indicator Code 1: 35 – Surgical dressings (price subject to floors and ceilings). Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology

Coverage: D – Special coverage instructions apply

Berenson-Eggers Type of Service (BETOS): D1A – Medical/surgical supplies
Type Of Service 1: S – Surgical dressings or other medical supplies (eff 04/95)

Anesthesia Base Unit Quantity: 0
Code Added Date: 19970101
Code Effective Date: 20030101
Action Code: N – No maintenance for this code