MyMedi-AI

A6241 — Hydrocolloid dressing, wound filler, dry form, sterile, per gram

HCPCS Level II A-code · short descriptor: “Hydrocolloid drg filler dry”

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 (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). 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 (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

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

A6241 Medicare fee schedule (October 2026)

Base (no modifier) Surgical dressings

Medicare allowable ranges from $3.66 to $4.38 depending on state and rural status.

Former-CBA payment limits: ceiling $3.66 · floor $3.11

StateNon-ruralRural
AK$3.71—
AL$3.66—
AR$3.66—
AZ$3.66—
CA$3.66—
CO$3.66—
CT$3.66—
DC$3.66—
DE$3.66—
FL$3.66—
GA$3.66—
HI$3.91—
IA$3.66—
ID$3.66—
IL$3.66—
IN$3.66—
KS$3.66—
KY$3.66—
LA$3.66—
MA$3.66—
MD$3.66—
ME$3.66—
MI$3.66—
MN$3.66—
MO$3.66—
MS$3.66—
MT$3.66—
NC$3.66—
ND$3.66—
NE$3.66—
NH$3.66—
NJ$3.66—
NM$3.66—
NV$3.66—
NY$3.66—
OH$3.66—
OK$3.66—
OR$3.66—
PA$3.66—
PR$4.38—
RI$3.66—
SC$3.66—
SD$3.66—
TN$3.66—
TX$3.66—
UT$3.66—
VA$3.66—
VI$3.66—
VT$3.66—
WA$3.66—
WI$3.66—
WV$3.66—
WY$3.66—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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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