| Short Description | Contact layer > 48 sq in |
| HCPCS Coverage Code | D - Special coverage instructions apply |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Action Effective Date | January 01, 2009 |
| HCPCS Code Added Date | January 01, 1997 |
| HCPCS Pricing Indicator Code | 46 - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts) |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Issues Manual Reference Section Number | |
| HCPCS Type Of Service Code | S - Surgical dressings or other medical supplies (eff 04/95) |
| HCPCS Anesthesia Base Unit Quantity | 0 |
