Hydrogels: Impregnated

Overview

Impregnated hydrogel wound dressings are gauzes and non-woven sponges, ropes and strips saturated with an amorphous hydrogel. Amorphous hydrogels are glycerin- and water-based products primarily manufactured for the purpose of wound hydration. These dressings help maintain a moist wound healing environment, promote granulation and epithelialization, and facilitate autolytic debridement. Because of the high water content of hydrogels, they typically cannot absorb large amounts of exudate. Hydrogel dressings are also available in sheet form.

Features

Impregnated hydrogel dressings feature the following general performance properties and attributes:
• Cooling action soothes and reduces pain
• Nonadherent
• Rehydrate the wound bed
• Fill in dead space
• Easy application and removal
• Can be used on infected wounds
• Facilitate autolytic debridement
• Atraumatic removal
• Can be used with topical medications

Indications

Impregnated hydrogels are indicated for use as a primary dressing in the treatment of minimally draining partial- and full-thickness wounds such as stage II-IV pressure ulcers, deep wounds, minor burns, infected wounds, dermal ulcers, skin tears, donor sites, radiation dermatitis and wounds with necrosis or slough.

Contraindications

Impregnated hydrogel dressings are contraindicated for use on wounds with heavy exudate.

Warnings

The following general warnings apply to impregnated hydrogel dressings. Always refer to manufacturer information for Warnings and Precautions for a specific product.

May dehydrate if left uncovered.
May cause maceration of periwound skin.
Not recommended for use on wounds with moderate to heavy exudate.
May require daily dressing changes.

Reimbursement Information

A6231 – Gauze, impregnated, hydrogel for direct wound contact, pad size less than 16 in²
A6232 – Gauze, impregnated, hydrogel for direct wound contact, pad size more than 16 in² but less than or equal to 48 in²
A6233 – Gauze, impregnated, hydrogel for direct wound contact, pad size more than 48 in²

Local Coverage Determination (LCD) Coverage Guidelines by Jurisdiction
Jurisdictions A, B, C and D:
Hydrogel dressings are covered when used on full-thickness wounds with minimal or no exudate (e.g., stage III or IV ulcers). Hydrogel dressings are not usually medically necessary for stage II ulcers. Documentation must substantiate the medical necessity for use of hydrogel dressings for stage II ulcers (e.g., location of ulcer is sacro-coccygeal area). Usual dressing change for hydrogel wound covers without adhesive border or hydrogel wound fillers is up to once per day. Usual dressing change for hydrogel wound covers with adhesive border is up to 3 times per week.

The quantity of hydrogel filler used for each wound must not exceed the amount needed to line the surface of the wound. Additional amounts used to fill a cavity are not medically necessary. Documentation must substantiate the medical necessity for code A6248 billed in excess of 3 units (fluid ounces) per wound in 30 days.

Use of more than one type of hydrogel dressing (filler, cover, or impregnated gauze) on the same wound at the same time is not reasonable and necessary.

Disclaimer: Information regarding coding, coverage and payment is provide as a service to users. Every effort has been made to ensure the accuracy of the information. However, Kestrel Health Information, Inc. and its subsidiaries do not represent, guarantee or warranty that the coding, coverage and payment information is error-free or that payment will be received. Users should always verify coverage policy, medical necessity requirements and coding instructions, and should review bulletins issued by the specific payer.

Hydrogels: Impregnated

Overview

Features

Indications

Contraindications

Warnings

Reimbursement Information

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