HYPAFIX 6 IN X 2 YD Adhesive Non-Woven Fabric Dressing Retention Rolls #4217 BenefitsCombines security with comfortHighly conformableProvides reliable fixation for catheters and drainage tubesAllows joints to be dressed without constraining movementIndicationsRetention of post-operative wound dressingsRetaining gauze and absorbent padsTo secure catheters and drainage tubesOrdering Codes / Reimbursement InformationUsual Allowable Amount: Based on frequency of change of wound cover; up to 2 units (36 sq. in.) per dressing change when wound cover is 16 sq. in. or less; up to 3 units (54 sq. in.) per dressing change when wound cover is 16 to 48 sq. in; up to 4 units (72 sq. in.) per dressing change when wound cover is greater than 48 sq. in. Note: a unit is based on 1-in. wide tapeSpecific Coverage Criteria: Covered when needed to hold on a wound cover, elastic roll gauze or non-elastic roll gauze; is not required when a wound cover with an adhesive border is used. The medical necessity for tape in these situations must be documented.Product #SizeRolls / CartonHCPCS Code42092 x 10 yard roll24A4452 (per 18 sq in)42104 x 10 yard roll24A4452 (per 18 sq in)42116 x 10 yard roll24A4452 (per 18 sq in)42152 x 2 yard roll36A4452 (per 18 sq in)42164 x 2 yard roll18A4452 (per 18 sq in)42176 x 2 yard roll12A4452 (per 18 sq in)abc: 10014465