HCPCS code K0746 – Absorptive wound dressing for use with suction pump

Key takeaways

HCPCS code K0746 is one absorptive wound dressing for a portable, home-model suction pump, with a pad above 48 square inches.

One unit buys one complete dressing change, including the porous dressing, the drainage tubing, and the occlusive seal.

The dressing attaches to the K0743 pump, and the system runs without a collection canister.

The Suction Pumps LCD (L33612) directs a denial wherever the non-covered A9272 device would serve the same wound.

Where several wounds sit close together, one K0746 set replaces the smaller sets they would otherwise need.

One unit of K0746 covers one dressing change

K0746 is a Level II HCPCS K-code for a wound care supply. CMS published the descriptor with the code, and the wording has not changed since it took effect.

Long descriptor: Absorptive wound dressing for use with suction pump, home model, portable. Pad size greater than 48 square inches.

Short descriptor: Absorp drg >48 suc pump.

The code arrived as part of a four-code set, effective July 1, 2011, in Transmittal 2236. K0743 is the pump. K0744, K0745, and K0746 are the dressing sets that go with it, separated only by pad size.

Policy article A52519 sets out what a single unit buys. Each K0744, K0745, or K0746 unit covers one complete dressing change. The set holds the components that change needs: the non-adherent porous dressing, the drainage tubing, and the occlusive dressing that seals the wound.

One detail separates this family from negative pressure wound therapy. The K0743 system runs without a collection canister, so exudate stays in the dressing material.

NPWT instead pairs an electrical pump (E2402) with a dressing set (A6550) and a disposable canister (A7000), all under a separate policy. A canister code on a K0746 claim signals the wrong system.

One more point before the coverage rules. Only a Medicare-enrolled, accredited DMEPOS supplier can bill K0746, and a physician practice needs its own supplier number to submit the claim.

Claims go to a DME MAC rather than the Part A/B MAC that processes office visits.

K0746 at a glance, before you build the claim

The table below holds the fields a biller checks before a K0746 claim goes out.

Why Medicare expects to deny K0746

Coverage for K0746 comes from the Suction Pumps LCD (L33612), and the dressing is payable only for use with the pump it serves. So the pump’s coverage test decides the dressing’s outcome.

The LCD sets a narrow clinical test first. Suction on wounds is appropriate only where the quantity of exudate exceeds what conservative measures can contain, such as surgical dressings and wound fillers.

A pad above 48 square inches usually means a wound that clears that clinical bar easily. That makes the second rule the one to read carefully, because it is not clinical at all.

Where a non-covered alternative exists (A9272), the LCD says a covered DME item (K0743) is not reasonable or necessary. It adds that K0743 will be denied as not reasonable and necessary when it is billed.

A9272 is the disposable wound suction device, and Medicare does not cover it. The code is all-inclusive, so supplies used with it are not separately billable. A supplier who bills K0743 and its dressings anyway should settle beneficiary liability before delivery.

Product coding is the third gate. The LCD denies wound suction pumps and their supplies that PDAC has not designated as qualified for K0743. Check the product against the PDAC Product Classification List before you ship it.

Place of service is the last gate. Items used with a suction pump are denied as non-covered in a nursing facility, which covers place of service 31 and 32. DME is statutorily excluded from payment in those settings.

Read the gates in order, because a claim that fails the first never reaches the second.

When one K0746 replaces several smaller dressing sets

K0746 is the only one of the three sets that policy article A52519 can require you to move up to. Two sizing rules decide it, and they pull in opposite directions.

The first rule pushes down. Select the dressing set by wound size, using the smallest size that covers the wound. Rounding up to a larger pad because it is on the shelf is a coding error.

The second rule pushes up. For multiple wounds located close together, a single large dressing must be used rather than multiple smaller sets. That applies wherever the wounds fit under one larger set.

So three nearby wounds that would each take a K0744 pad become one K0746 unit when a single pad covers all three. Billing them as three smaller units overstates the service and misstates the dressing you applied.

Record the measurement that drove the decision. A note showing the combined area that one pad covered is what turns a larger code into a defensible one.

The records that keep a K0746 claim payable

K0746 documentation follows the DMEPOS standard requirements, with one difference worth planning for. K0746 is a repeat supply, so the refill records carry as much weight as the original order.

A Standard Written Order must reach the supplier before the claim is submitted. The SWO replaced the detailed written order in 2020, so an intake template that still asks for a DWO is out of date.

Certificates of medical necessity no longer apply either. CMS retired them for dates of service on or after January 1, 2023.

A complete K0746 record holds the following:

• Standard Written Order (SWO): the beneficiary’s name, the order date, a description of the item, the quantity, and the treating practitioner’s name and signature.
• Wound notes: wound type, size, duration, exudate volume, and the conservative measures already tried. The LCD’s coverage test turns on exudate exceeding what dressings and fillers can contain.
• Pad size support: the wound measurement that puts the pad above 48 square inches, or the combined area of nearby wounds covered by one set.
• Proof of delivery: a signed, dated record listing the item, the quantity, and the delivery date.
• Refill records: contact with the beneficiary no sooner than 30 calendar days before the current supply runs out, plus a documented affirmative response.
• Continued medical need: notes showing the wound and the pump are still in use for the period billed.
• PDAC listing: evidence that the pump and dressing you supplied are coded for K0743 use.

Two delivery limits sit alongside those records. A refill ships no sooner than 10 calendar days before the current supply runs out. No supplier dispenses more than a three-month quantity at a time.

Gather all of it before the claim goes out rather than after a denial arrives. A reviewer can ask for the refill history months after the wound has healed.

GA or GZ decides who pays for the dressing

Neither the Suction Pumps LCD nor policy article A52519 sets a KX requirement for K0743 through K0746. There is no medical policy checkbox for KX to attest to here, so adding it by habit gives the payer no extra information.

The modifiers that carry weight are the liability modifiers. Because the LCD expects a denial where A9272 is the reasonable alternative, the ABN decision drives which one belongs on the line.

GA and GZ look alike and carry opposite consequences. GA means an ABN is on file, so the beneficiary can be billed. GZ means no ABN, so the balance is yours.

Issue the ABN before delivery. One signed afterwards protects nobody, and the line then has to carry GZ.

Units, not billing periods, drive K0746 payment

K0746 is paid under the Medicare DMEPOS fee schedule as a supply used with covered DME. Allowed amounts vary by state and DME MAC jurisdiction, so there is no single national rate to quote.

Units drive the total. One unit is one complete dressing change, so two changes in a week bill as two units. Pull the current year’s allowed amount from the CMS DMEPOS fee schedule file before you bill.

Put that January review on the calendar for every code you bill, K0746 included. A rate that moved quietly in the new year is an easy source of underpayment.

K0746 needs no prior authorization, but check the plan

K0746 does not appear on the CMS required prior authorization list. That list covers power mobility devices, pressure reducing support surfaces, lower limb prosthetics, spinal and knee orthoses, and pneumatic compression devices.

So there is no CMS prior authorization step for the dressing, and no authorization number to append to the claim. The gates sit elsewhere, in PDAC product coding, the LCD’s reasonable and necessary test, and the refill rules.

Other payers write their own rules, though. Medicare Advantage plans, state Medicaid programs, and commercial payers can all require prior authorization for wound suction supplies where traditional Medicare does not.

CMS updates the required list by Federal Register notice, so recheck it each year instead of trusting a saved copy.

The patient’s address decides which DME MAC pays

DMEPOS claims go to one of four DME MACs rather than the Part A/B MAC that handles physician claims. Jurisdiction follows the beneficiary’s permanent address, not the supplier’s location.

So a supplier in California shipping K0746 dressings to a beneficiary who lives in Florida bills Jurisdiction C, which CGS administers.

Cross-border deliveries and beneficiaries who winter in another state are where this gets missed. CMS keeps the current contractor assignments on file if you need to confirm one.

Supplier requirements for billing K0746:

• An active DMEPOS supplier number in CMS PECOS
• DMEPOS accreditation from a CMS-approved accrediting organization
• A surety bond and a physical location that meets the CMS supplier standards
• Separate enrollment for each location, since one enrollment does not cover branches

Related codes in the K0743 wound suction family

K0746 sits in a four-code family for portable wound suction. Choosing between the three dressing codes is a measurement decision, because pad size is the only variable that separates them.

The A6 surgical dressing codes are a separate family, and they are the ones K0746 gets confused with most often. An alginate or specialty absorptive dressing applied without a suction pump belongs there, not here.

The pump side of the same claim runs on K0743, and the middle pad size runs on K0745. Verify every descriptor against the current year’s CMS HCPCS file before you bill into a new year.

There is no covered diagnosis list for K0746

The Suction Pumps policy publishes no covered diagnosis list for K0746. The ICD-10-CM lists inside policy article A52519 apply to the airway suction codes instead, including E0600, A4605, A4624, A7002, and A7047.

Diagnosis selection here is therefore a documentation exercise rather than a lookup. Report the code that names the wound under treatment, and make sure the record supports the exudate burden the LCD asks about.

Wounds large enough to need a pad above 48 square inches usually come from a short set of families:

• L97.- non-pressure chronic ulcer of the lower limb, coded to site, laterality, and severity
• L89.- pressure ulcer, coded to site and stage, with stage 3 and stage 4 wounds the likeliest at this size
• E11.621 type 2 diabetes with foot ulcer, plus an additional L97.- code for the ulcer site
• I83.0- and I83.2- varicose veins of the lower extremities with ulcer
• T81.31- disruption of an external surgical wound, with the seventh character for the encounter

Code to the highest level of specificity the record supports. A wound code missing its site or laterality trips a MAC edit before a reviewer ever reads the claim.

Note what is not on that list. Catheter-site and vascular device complications belong to infusion therapy, and they do not support a suction pump dressing.

Eight mistakes that sink K0746 claims

K0746 denials cluster around a handful of causes, and most of them are set in motion before the claim is built.

1. Reading the code as an infusion supply. K0746 is used with a suction pump, not with an infusion pump. A supply tied to an IV line belongs to a different code family.
2. Billing the dressing without a qualifying pump. K0744 through K0746 are payable only for use with the K0743 pump. If PDAC has not listed the product, the LCD denies the pump and its supplies.
3. Rounding up to the larger pad. K0746 starts above 48 square inches. Use the smallest set that covers the wound, and let the measurement pick the code.
4. Splitting nearby wounds across several small dressings. A52519 says to cover wounds close together with one larger set where they fit under it.
5. Billing one unit for a whole period. One unit is one complete dressing change, so units should match the changes furnished.
6. Adding a canister code. The K0743 system holds exudate in the dressing, and A7000 belongs to NPWT instead.
7. Shipping refills automatically. Contact must happen no sooner than 30 days before the supply runs out, with a documented affirmative response.
8. Appending KX out of habit. The Suction Pumps policy sets no KX requirement for these codes, so GA or GZ is the decision that matters.

Track denials by code and reason rather than one claim at a time. When K0746 denials pile up on a single reason code, the fix belongs upstream in intake or product coding. Our guide to denial codes maps the common CARC and RARC entries back to their root causes.

Run this check before the claim goes out

K0746 claims fail for administrative reasons far more often than clinical ones. Six checks catch most of it, and none of them take long:

• The pad was measured, and the code came from that measurement.
• Nearby wounds were assessed together, so one set was not split into several.
• PDAC lists the pump and the dressing you shipped for use with K0743.
• The Standard Written Order is signed, dated, and on file before submission.
• Units match the dressing changes furnished, not the length of the billing period.
• The liability modifier matches the ABN, so GA with a signature and GZ without one.

Two of those six sit outside billing. The measurement and the PDAC listing belong to whoever picks the product. That makes them a standing conversation with the clinical side, not a rework queue.

How Pabau keeps DMEPOS supply claims clean

Most K0746 denials start as a small mismatch between the record and the claim. The wound notes describe three dressing changes and the claim carries one unit.

The order sits in a shared drive, the delivery note sits in somebody’s inbox, and the biller rebuilds both from memory.

Practice management software like Pabau closes that distance by building the claim from the record itself. Its claims management software holds the order, the delivery note, and the claim on one record.

The CMS-1500 is pre-filled from that record, so the dressing changes you documented become the units on the line.

HCPCS and ICD-10 lookup libraries sit behind a search icon, and required claim fields have to be complete before submission unlocks. Wound measurements stay on the patient record, next to the code they justify.

On the US pipeline, the Claim.MD integration runs eligibility checks, posts electronic remittances, and tracks claim status. So when a K0746 line comes back denied, the reason code sits next to the record it came from.

That shortens the loop between a denial and its fix, which is where DMEPOS revenue usually leaks.

Keep DMEPOS supply claims clean from the first line

Pabau pre-fills the CMS-1500 from the clinical record, carries HCPCS and ICD-10 lookup libraries, and checks required claim fields before submission unlocks.

Book a demo

Conclusion

K0746 is a wound care supply code, and every billing decision on it follows from that. Pad size picks the code. The K0743 pump’s coverage decides whether the dressing pays at all. The refill record keeps it payable month after month.

The Suction Pumps LCD is blunt about the odds. Where the non-covered A9272 device would serve the same purpose, K0743 and its dressings get denied. Read that before delivery rather than after a denial.

Do that, and you can set expectations with an ABN and code the line correctly first time. Book a demo to see how Pabau turns a wound record into a DMEPOS claim without a second round of data entry.

Continue your research

Need the pump side of the same claim? HCPCS code K0743 covers the portable wound suction pump that K0746 dressings attach to.

Wondering which pad size code applies? HCPCS code K0745 covers the middle band, above 16 and up to 48 square inches.

Want a clean-claim checklist for billing teams? Submitting a clean claim outlines the core elements every DMEPOS claim must have before it hits the MAC.

Frequently asked questions