Dynamic List Information
Dynamic List Data
HCPCS Code
A6219
On Master List?
Yes
Prior Authorization Required?
No
PA Effective Dates
N/A
F2F and Written Order Prior to Delivery?
No
F2F and WOPD Effective Dates
N/A
Description: Gauze, non-impregnated, sterile, pad size 16 square inch or less, with any size adhesive border, each dressing