Wound Care
Medicare Guidelines

DRESSING

MAXIMUM FREQUENCY

DRAINAGE

THICKNESS/STAGE

SPECIAL COMMENTS

Gauze

Up to 3x/Day

Any

Any


Roll Gauze

Up to 3x/Day

Any

Any


Bordered Gauze

Up to 1x/Day

Any

Any


Composite Dressing

Up to 3x/Week

Any

Any


Impregnated Gauze

Up to 1x/Day

Any

Any


Contact Layer

Up to 1x/Week

Any

Any


Hydrocolloid Dressing

Up to 3x/Week

Minimal/Mod

Any


Transparent Film

Up to 3x/Week

Minimal Partial Thickness



Specialty Absorptive Dressing Without Border

Up to 1x/Day

Mod/Heavy

**Full Thickness/Stage 3 or 4


Specialty Absorptive Dressing With Border

Up to 1x/Every Other Day

Mod/Heavy

**Full Thickness/Stage 3 or 4


Calcium Alginate Dressing

Up to 1x/Day

Mod/Heavy

**Full Thickness/Stage 3 or 4

Includes Silver Alginates

Foam/Bordered Foam Dressing

Up to 3x/Week

Mod/Heavy

**Full Thickness/Stage 3 or 4

Includes Silver Foams

Hydrogel Filler (Tube)

Up to 3 ounces/Month

None/Minimal

**Full Thickness/Stage 3 or 4

Wound must have cavity

Hydrogel Gauze/Sheet

Up to 1x/Day

None/Minimal

**Full Thickness/Stage 3 or 4


Medicare will cover a primary and secondary surgical dressing for each wound, if the wound qualifies for Part B benefits and the product type and quantity are medically necessary for the specific characteristics of the wound.

*  Partial Thickness/Stage 2:  Skin loss involving epidermis, dermis or both. The ulcer is superficial and presents clinically as an abrasion, blister or shallow crater.

** Full Thickness/Stage 3:   Skin loss involving damage to, or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.

*** Full Thickness/Stage 4:   Skin loss with extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures (e.g. tendon, joint capsule). Undermining and sinus tracts also may be associated with Stage 4 pressure ulcers.

Dressing size must be based on and appropriate to the size of the wound.

Unless otherwise noted, the information on this page was obtained from the Centers for Medicare & Medicaid Services (Local Coverage Determination for Surgical Dressings – L11460). Be advised that information contained herein is intended to serve as a useful reference for Informational purposes only and is not information or guarantee of coverage. This information is intended for use only by competent healthcare professionals exercising judgement in providing care. Gaboro Medical Supply cannot be held responsible for the continued currency of or any errors or omissions in the information.

Priority Patient Care is Our Mission

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info@gaboromed.com

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