Surgical Dressings (HCPCS A6010, A6196, and A6197) Notification of Service Specific Post-Payment Review

Noridian Jurisdiction A, DME MAC, Medical Review is initiating service specific post-payment medical record review of claims for the following HCPCS codes:

  • A6010: COLLAGEN BASED WOUND FILLER, DRY FORM, STERILE, PER GRAM OF COLLAGEN
  • A6196: ALGINATE OR OTHER FIBER GELLING DRESSING, WOUND COVER, STERILE, PAD SIZE 16 SQ. IN. OR LESS, EACH DRESSING
  • 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

Service specific reviews are initiated to prevent improper payments for services which present possible sustained or high-level payment errors. This review is being initiated based on data analysis identifying probable vulnerabilities. Please see the Medical Record Review Results page for further information.

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