A6197

A6197 — Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing

Q: What is HCPCS code A6197?

A6197 is a HCPCS Level II code for alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.

Q: Does Medicare cover A6197?

The CMS HCPCS file marks A6197 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.

Q: How is A6197 paid under the physician fee schedule?

A6197 carries PFS status code P. Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.

HCPCSActiveBETOS D1A

A6197 is a HCPCS Level II code for alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Special coverage instructions apply

There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusP

Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.

Global period: XXX

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

Medically Unlikely Edits — units per day

The most units of A6197 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.

practitioner: 0 — never payable

The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.

The CMS record for A6197

Long descriptor: Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
Short descriptor: Alginate drsg >16 <=48 sq in
Added: January 1, 1997
BETOS: D1A
Pricing indicator: 35 — DMEPOS

Codes adjacent to A6197

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A6197 is not quite right, the correct code is very often within a few positions of it.

A6011Collagen based wound filler, gel/paste, per gram of collagen
A6021Collagen dressing, sterile, size 16 sq. in. or less, each
A6022Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each
A6023Collagen dressing, sterile, size more than 48 sq. in., each
A6024Collagen dressing wound filler, sterile, per 6 inches
A6025Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each
A6154Wound pouch, each
A6196Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing
A6198Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing
A6199Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches
A6203Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing
A6204Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
A6205Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
A6206Contact layer, sterile, 16 sq. in. or less, each dressing
A6207Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
A6208Contact layer, sterile, more than 48 sq. in., each dressing

Questions about A6197

What is HCPCS code A6197?

A6197 is a HCPCS Level II code for alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.

Does Medicare cover A6197?

The CMS HCPCS file marks A6197 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.

How is A6197 paid under the physician fee schedule?

A6197 carries PFS status code P. Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.