MyMedi-AI

A6240 — Hydrocolloid dressing, wound filler, paste, sterile, per ounce

HCPCS Level II A-code · short descriptor: “Hydrocolld drg filler paste”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Surgical dressings
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A6240 Medicare fee schedule (April 2026)

Base (no modifier) Surgical dressings

Medicare allowable ranges from $17.45 to $20.94 depending on state and rural status.

Former-CBA payment limits: ceiling $17.45 · floor $14.83

StateNon-ruralRural
AK$17.65
AL$17.45
AR$17.45
AZ$17.45
CA$17.45
CO$17.45
CT$17.45
DC$17.45
DE$17.45
FL$17.45
GA$17.45
HI$18.84
IA$17.45
ID$17.45
IL$17.45
IN$17.45
KS$17.45
KY$17.45
LA$17.45
MA$17.45
MD$17.45
ME$17.45
MI$17.45
MN$17.45
MO$17.45
MS$17.45
MT$17.45
NC$17.45
ND$17.45
NE$17.45
NH$17.45
NJ$17.45
NM$17.45
NV$17.45
NY$17.45
OH$17.45
OK$17.45
OR$17.45
PA$17.45
PR$20.94
RI$17.45
SC$17.45
SD$17.45
TN$17.45
TX$17.45
UT$17.45
VA$17.45
VI$17.45
VT$17.45
WA$17.45
WI$17.45
WV$17.45
WY$17.45
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related A-codes

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