Revised February 2015

HCPCS Coding Information 3M Health Care Products

• Ostomy Products • Professional Skin Care Products • Dressings and Bandages • Medical Tapes • Rehabilitation Products

NOTE: Please see Disclaimer information on page one. 1

Disclaimer: The reimbursement information provided by 3M Health Care and its representatives is intended to provide general information relevant to coding for 3M products. Insurers’ reimbursement policies can vary, however, and the use of the codes discussed here does not guarantee that an insurer will cover or pay at any particular level.

Ostomy Products

3M™ Cavilon™ No Sting Barrier Film HCPCS

Catalog No. Code HCPCS Generic Category 3343 A4369 Skin barrier, liquid 3344 A5120 Skin barrier, wipes 3345 A4369 Skin barrier, liquid 3346 A4369 Skin barrier, liquid

Professional Skin Care Products

3M™ Cavilon™ 3-in-1 Incontinence Care Lotion HCPCS

Catalog No. Code HCPCS Generic Category

3383 A6250 Skin sealants, protectants, moisturizers, ointments

3M™ Cavilon™ Antifungal Cream HCPCS

Catalog No. Code HCPCS Generic Category

3389 A6250 Skin sealants, protectants, moisturizers, ointments

3390 A6250 Skin sealants, protectants, moisturizers, ointments

3M™ Cavilon™ Durable Barrier Cream Fragrance Free HCPCS

Catalog No. Code HCPCS Generic Category

3353 A6250 Skin sealants, protectants, moisturizers, ointments

3354 A6250 Skin sealants, protectants, moisturizers, ointments

3355 A6250 Skin sealants, protectants, moisturizers, ointments

3M™ Cavilon™ Extra Dry Skin Cream HCPCS

Catalog No. Code HCPCS Generic Category

9205 A6250 Skin sealants, protectants, moisturizers, ointments

9215 A6250 Skin sealants, protectants, moisturizers, ointments

NOTE: Please see Disclaimer information on page one. 2

Professional Skin Care Products (continued)

3M™ Cavilon™ Moisturizing Hand Lotion HCPCS

Catalog No. Code HCPCS Generic Category

9205 A6250 Skin sealants, protectants, moisturizers, ointments

9215 A6250 Skin sealants, protectants, moisturizers, ointments

3M™ Cavilon™ No-Rinse Skin Cleanser HCPCS

Catalog No. Code HCPCS Generic Category

3380 A6260 Wound cleansers, any type, any size

3M™ Cavilon™ No Sting Barrier Film HCPCS

Catalog No. Code HCPCS Generic Category

3343 A6250 Skin sealants, protectants, moisturizers, ointments

3344 A6250 Skin sealants, protectants, moisturizers, ointments

3345 A6250 Skin sealants, protectants, moisturizers, ointments

3346 A6250 Skin sealants, protectants, moisturizers, ointments

NOTE: Please see Disclaimer information on page one. 3

Dressings and Bandages

3M™ Coban™ Self-Adherent Wrap* HCPCS

Catalog No. Code HCPCS Generic Category 1581 A6453 Self-adherent bandage, elastic, width less than three inches 1581B (Blue) A6453 Self-adherent bandage, elastic, width less than three inches 1582 A6453 Self-adherent bandage, elastic, width less than three inches 1582B (Blue) A6453 Self-adherent bandage, elastic, width less than three inches 1583 A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583A (Rainbow Pack) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583B (Blue) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583G (Green) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583N (Neon Pack) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583R (Red) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583S (Sterile) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583W (White) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1583Y (Yellow) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1584 A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1584B (Blue) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1584L A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1584S (Sterile) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 1586 A6455 Self-adherent bandage, elastic, width greater than or equal to five inches 1586S (Sterile) A6455 Self-adherent bandage, elastic, width greater than or equal to five inches

*Caution: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions.

NOTE: Please see Disclaimer information on page one. 4

Dressings and Bandages (continued)

3M™ Nexcare™ Coban™ Self-Adherent Wrap* HCPCS

Catalog No. Code HCPCS Generic Category Retail Packages: H1581 A6453 Self-adherent bandage, elastic, width less than three inches H1582 A6453 Self-adherent bandage, elastic, width less than three inches H1583 A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches

*Caution: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions.

3M™ Coban™ LF (Latex Free) Self-Adherent Wrap with Hand Tear HCPCS

Catalog No. Code HCPCS Generic Category 2081 A6453 Self-adherent bandage, elastic, width less than three inches 2081C (Brights) A6453 Self-adherent bandage, elastic, width less than three inches 20815 A6453 Self-adherent bandage, elastic width less than three inches 20815C (Brights) A6453 Self-adherent bandage, elastic, width less than three inches 2082 A6453 Self-adherent bandage, elastic, width less than three inches 2082C (Brights) A6453 Self-adherent bandage, elastic, width less than three inches 2082S (Sterile) A6453 Self-adherent bandage, elastic, width less than three inches 2083 A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 2083C (Brights) A6454 Self-adherent bandage, elastic,

width greater than or equal to three inches and less than five inches

2083S (Sterile) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 2084 A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 2084C (Brights) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 2084L A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 2084S (Sterile) A6454 Self-adherent bandage, elastic, width greater than or equal to three inches and less than five inches 2086 A6455 Self-adherent bandage, elastic, width greater than or equal to five inches 2086S (Sterile) A6455 Self-adherent bandage, elastic, width greater than or equal to five inches

NOTE: Please see Disclaimer information on page one. 5

Dressings and Bandages (continued)

3M™ Coban™ 2 Layer Compression System HCPCS Catalog No. Code HCPCS Generic Category

2094 Roll #1 A6441 Padding bandage, width greater than or equal to three inches and less than five inches Roll #2 A6452 High compression bandage, width greater than or equal to three inches and less than five inches

3M™ Coban™ 2 Layer Lite Compression System HCPCS

Catalog No. Code HCPCS Generic Category

2794 Roll #1 A6441 Padding bandage, width greater than or equal to three inches and less than five inches Roll #2 A6452 High compression bandage, width greater than or equal to three inches and less than five inches

3M™ Medipore™ +Pad Soft Cloth Adhesive Wound Dressing HCPCS

Catalog No. Code HCPCS Generic Category

3562 A6219 Gauze, nonimpregnated, with border 3564 A6219 Gauze, nonimpregnated, with border 3566 A6219 Gauze, nonimpregnated, with border 3568 A6219 Gauze, nonimpregnated, with border 3569 A6219 Gauze, nonimpregnated, with border 3570 A6219 Gauze, nonimpregnated, with border 3571 A6219 Gauze, nonimpregnated, with border 3573 A6220 Gauze, nonimpregnated, with border

3M™ Tegaderm™ Absorbent Clear Acrylic Dressing HCPCS

Catalog No. Code HCPCS Generic Category

Ovals: 90800 A6203 Composite dressing 90801 A6203 Composite dressing 90803 A6203 Composite dressing

Sacral: 90807 A6204 Composite dressing

Squares: 90802 A6203 Composite dressing 90805 A6204 Composite dressing

3M™ Tegaderm™ Ag Mesh Dressing with Silver HCPCS

Catalog No. Code HCPCS Generic Category

90500 A6402 Gauze, nonimpregnated, without border 90501 A6403 Gauze, nonimpregnated, without border 90502 A6403 Gauze, nonimpregnated, without border 90503 A6404 Gauze, nonimpregnated, without border

NOTE: Please see Disclaimer information on page one. 6

Dressings and Bandages (continued)

3M™ Tegaderm™ Alginate Ag Silver Dressing HCPCS

Catalog No. Code HCPCS Generic Category

90301 A6196 Alginate dressing, wound cover 90303 A6197 Alginate dressing, wound cover 90305 A6198 Alginate dressing, wound cover 90307 A6199 Alginate dressing, wound filler

3M™ Tegaderm™ CHG Chlorhexidine Gluconate I.V. Port Dressing HCPCS

Catalog No. Code HCPCS Generic Category

1665 A6258 Transparent film

3M™ Tegaderm™ CHG Chlorhexidine Gluconate I.V. Securement Dressing HCPCS

Catalog No. Code HCPCS Generic Category

1657 A6257 Transparent film 1658 A6257 Transparent film 1659 A6258 Transparent film 1660 A6257 Transparent film

3M™ Tegaderm™ Diamond Pattern Film Dressing HCPCS

Catalog No. Code HCPCS Generic Category

1679 A6257 Transparent film 1684 A6257 Transparent film 1686 A6258 Transparent film

3M™ Tegaderm™ High Gelling Alginate Dressing HCPCS

Catalog No. Code HCPCS Generic Category 90212 A6196 Alginate dressing, wound cover 90220 A6199 Alginate dressing, wound filler

3M™ Tegaderm™ High Integrity Alginate Dressing HCPCS

Catalog No. Code HCPCS Generic Category 90112 A6196 Alginate dressing, wound cover 90120 A6199 Alginate dressing, wound filler

NOTE: Please see Disclaimer information on page one. 7

Dressings and Bandages (continued)

3M™ Tegaderm™ High Performance Foam Adhesive Dressing HCPCS

Catalog No. Code HCPCS Generic Category 90610 A6212 Foam dressing, wound cover 90611 A6212 Foam dressing, wound cover 90612 A6212 Foam dressing, wound cover 90613 A6212 Foam dressing, wound cover 90614 A6212 Foam dressing, wound cover 90615 A6212 Foam dressing, wound cover 90616 A6213 Foam dressing, wound cover Heel/elbow design: 90619 A6212 Foam dressing, wound cover_____

3M™ Tegaderm™ High Performance Foam Non-Adhesive Dressing HCPCS

Catalog No. Code HCPCS Generic Category 90600 A6209 Foam dressing, wound cover 90601 A6209 Foam dressing, wound cover 90602 A6210 Foam dressing, wound cover 90603 A6211 Foam dressing, wound cover 90604 A6209 Foam dressing, wound cover 90605 A6211 Foam dressing, wound cover

3M™ Tegaderm™ HP Transparent Film Dressing Frame Style HCPCS

Catalog No. Code HCPCS Generic Category

9519HP A6257 Transparent film 9534HP A6257 Transparent film 9536HP A6258 Transparent film 9543HP A6258 Transparent film 9545HP (oval) A6257 Transparent film 9546HP (oval) A6257 Transparent film 9548HP (oval) A6258 Transparent film

3M™ Tegaderm™ Hydrocolloid Dressing HCPCS

Catalog No. Code HCPCS Generic Category Ovals: 90001 A6237 Hydrocolloid dressing 90003 A6237 Hydrocolloid dressing 90004 A6238 Hydrocolloid dressing

Sacral: 90007 A6238 Hydrocolloid dressing

Squares: 90002 A6234 Hydrocolloid dressing 90005 A6235 Hydrocolloid dressing

NOTE: Please see Disclaimer information on page one. 8

Dressings and Bandages (continued)

3M™ Tegaderm™ Hydrocolloid Thin Dressing HCPCS

Catalog No. Code HCPCS Generic Category Ovals: 90021 A6237 Hydrocolloid dressing 90023 A6237 Hydrocolloid dressing 90024 A6238 Hydrocolloid dressing

Squares: 90022 A6234 Hydrocolloid dressing

3M™ Tegaderm™ Hydrogel Wound Filler HCPCS

Catalog No. Code HCPCS Generic Category 91110 A6248 Hydrogel dressing, wound filler 91111 A6248 Hydrogel dressing, wound filler

3M™ Tegaderm™ I.V. Advanced Securement Dressing HCPCS

Catalog No. Code HCPCS Generic Category

1680 A6257 Transparent film 1682 A6257 Transparent film 1683 A6257 Transparent film 1685 A6257 Transparent film 1688 A6258 Transparent film 1689 A6258 Transparent film

3M™ Tegaderm™ I.V. Securement Dressing HCPCS

Catalog No. Code HCPCS Generic Category

9525HP A6257 Transparent film

3M™ Tegaderm™ I.V. Transparent Film Dressing with Adhesive-Free Window HCPCS

Catalog No. Code HCPCS Generic Category

1668 A6258 Transparent film

3M™ Tegaderm™ I.V. Transparent Film Dressing with Border HCPCS

Catalog No. Code HCPCS Generic Category

1610 A6257 Transparent film 1633 A6257 Transparent film 1635 A6257 Transparent film 1650 A6258 Transparent film 1655 A6257 Transparent film

NOTE: Please see Disclaimer information on page one. 9

Dressings and Bandages (continued)

3M™ Tegaderm™ Non-Adherent Contact Layer HCPCS

Catalog No. Code HCPCS Generic Category 5642 A6206 Contact layer 5643 A6207 Contact layer 5644 A6208 Contact layer

3M™ Tegaderm™ +Pad Film Dressing with Non-Adherent Pad HCPCS

Catalog No. Code HCPCS Generic Category

3582 A6203 Composite dressing 3584 A6203 Composite dressing 3586 A6203 Composite dressing 3587 (oval) A6203 Composite dressing 3588 A6203 Composite dressing 3589 A6203 Composite dressing 3590 A6203 Composite dressing 3591 A6203 Composite dressing 3593 A6204 Composite dressing

3M™ Tegaderm™ Silicone Foam Border Dressing HCPCS

Catalog No. Code HCPCS Generic Category

90640 A6212 Foam dressing, wound cover 90641 A6212 Foam dressing, wound cover 90642 A6213 Foam dressing, wound cover

3M™ Tegaderm™ Superabsorber Dressing HCPCS

Catalog No. Code HCPCS Generic Category

90701 A6196 Alginate dressing, wound cover 90702 A6197 Alginate dressing, wound cover 90703 A6197 Alginate dressing, wound cover 90704 A6198 Alginate dressing, wound cover

NOTE: Please see Disclaimer information on page one. 10

Dressings and Bandages (continued)

3M™ Tegaderm™ Transparent Film Dressing HCPCS

Catalog No. Code HCPCS Generic Category

1614 A6257 Transparent film 1616 A6258 Transparent film 1620 A6257 Transparent film 1621 A6258 Transparent film 1622W A6257 Transparent film 1624W A6257 Transparent film 1626 A6258 Transparent film 1626W A6258 Transparent film 1627 A6258 Transparent film 1628 A6258 Transparent film 1629 A6259 Transparent film 1630 A6258 Transparent film 1634 A6257 Transparent film

Small Quantity Packages: 9505W A6257 Transparent film 9506W A6258 Transparent film

Retail Packages H1624 A6257 Transparent film H1626 A6258 Transparent film

3M™ Tegaderm™ Transparent Film Roll HCPCS

Catalog No. Code HCPCS Generic Category

16002 A6257-A6259 Transparent film 16004 A6257-A6259 Transparent film 16006 A6257-A6259 Transparent film

3M™ Wound Cleanser HCPCS

Catalog No. Code HCPCS Generic Category 91101 A6260 Wound cleansers, any type, any size

NOTE: Please see Disclaimer information on page one. 11

Medical Tapes

3M™ Blenderm™ Tape HCPCS

Catalog No. Code HCPCS Generic Category 1525-0 A4452 Tape, waterproof 1525-1 A4452 Tape, waterproof 1525-2 A4452 Tape, waterproof

3M™ Cloth Adhesive Tape HCPCS

Catalog No. Code HCPCS Generic Category 2950-0 A4450 Tape, non-waterproof 2950-1 A4450 Tape, non-waterproof 2950-2 A4450 Tape, non-waterproof 2950-3 A4450 Tape, non-waterproof

3M™ Durapore™ Tape HCPCS

Catalog No. Code HCPCS Generic Category 1538-0 A4452 Tape, waterproof 1538-1 A4452 Tape, waterproof 1538-2 A4452 Tape, waterproof 1538-3 A4452 Tape, waterproof

Single Use: 1538S-1 A4452 Tape, waterproof 1538S-2 A4452 Tape, waterproof

3M™ Kind Removal Silicone Tape HCPCS Catalog No. Code HCPCS Generic Category 2770-1 A4452 Tape, waterproof 2770-2 A4452 Tape, waterproof 2775-0 A4452 Tape, waterproof 2775-1 A4452 Tape, waterproof 2775-2 A4452 Tape, waterproof Short Rolls: 2770S-1 A4452 Tape, waterproof 2770S-2 A4452 Tape, waterproof

3M™ Medipore™ Dress-It Pre-Cut Dressing Covers HCPCS Catalog No. Code HCPCS Generic Category 2954 A4452 Tape, waterproof 2955 A4452 Tape, waterproof 2956 A4452 Tape, waterproof 2957 A4452 Tape, waterproof 2958 A4452 Tape, waterproof

NOTE: Please see Disclaimer information on page one. 12

Medical Tapes (continued)

3M™ Medipore™ H Soft Cloth Tape HCPCS Catalog No. Code HCPCS Generic Category 2861 A4452 Tape, waterproof 2862 A4452 Tape, waterproof 2863 A4452 Tape, waterproof 2864 A4452 Tape, waterproof 2866 A4452 Tape, waterproof 2868 A4452 Tape, waterproof

Short Rolls: 2862S A4452 Tape, waterproof 2864S A4452 Tape, waterproof 2866S A4452 Tape, waterproof

3M™ Medipore™ Soft Cloth Tape HCPCS Catalog No. Code HCPCS Generic Category 2961 A4452 Tape, waterproof 2962 A4452 Tape, waterproof 2963 A4452 Tape, waterproof 2964 A4452 Tape, waterproof 2966 A4452 Tape, waterproof 2968 A4452 Tape, waterproof

Short Rolls: 2962S A4452 Tape, waterproof 2964S A4452 Tape, waterproof 2966S A4452 Tape, waterproof

3M™ Microfoam™ Tape HCPCS Catalog No. Code HCPCS Generic Category 1528-1 A4452 Tape, waterproof 1528-2 A4452 Tape, waterproof 1528-3 A4452 Tape, waterproof 1528-4 A4452 Tape, waterproof

NOTE: Please see Disclaimer information on page one. 13

Medical Tapes (continued)

3M™ Micropore™ Tape HCPCS Catalog No. Code HCPCS Generic Category Standard: 1530-0 A4450 Tape, non-waterproof 1530-1 A4450 Tape, non-waterproof 1530-2 A4450 Tape, non-waterproof 1530-3 A4450 Tape, non-waterproof

Single Use 1530S-1 A4450 Tape, non-waterproof 1530S-2 A4450 Tape, non-waterproof

Tan: 1533-0 A4450 Tape, non-waterproof 1533-1 A4450 Tape, non-waterproof 1533-2 A4450 Tape, non-waterproof

Dispenser Pack: 1535-0 A4450 Tape, non-waterproof 1535-1 A4450 Tape, non-waterproof 1535-2 A4450 Tape, non-waterproof 1535-3 A4450 Tape, non-waterproof

3M™ Transpore™ Tape

HCPCS Catalog No. Code HCPCS Generic Category 1527-0 A4452 Tape, waterproof 1527-1 A4452 Tape, waterproof 1527-2 A4452 Tape, waterproof 1527-3 A4452 Tape, waterproof

Single Use: 1527S-1 A4452 Tape, waterproof 1527S-2 A4452 Tape, waterproof

3M™ Transpore™ White Tape HCPCS Catalog No. Code HCPCS Generic Category 1534-0 A4452 Tape, waterproof 1534-1 A4452 Tape, waterproof 1534-2 A4452 Tape, waterproof 1534-3 A4452 Tape, waterproof 1527S-2 A4452 Tape, waterproof Single Use 1534S-1 A4452 Tape, waterproof 1534S-2 A4452 Tape, waterproof

3M™ Universal Cloth Adhesive Tape HCPCS Catalog No. Code HCPCS Generic Category 881-1 A4452 Tape, waterproof 881-2 A4452 Tape, waterproof 881-3 A4452 Tape, waterproof

See page 15 for Medical Tapes—Conversion to 18 Square Inch Units.

NOTE: Please see Disclaimer information on page one. 14

Rehabilitation Products

3M™ Reston™ Self-Adhering Foam Pad HCPCS

Catalog No. Code HCPCS Generic Category Medium Support: 1560M E1399 DME, miscellaneous High Support: 1561H E1399 DME, miscellaneous

3M™ Reston™ Self-Adhering Foam Roll HCPCS

Catalog No. Code HCPCS Generic Category Light Support: 1563L E1399 DME, miscellaneous

NOTE: Please see Disclaimer information on page one. 15

Medical Tapes—Conversion to 18 Square Inch Units 3M™ Medical Tapes Catalog No. Size No. of 18 Sq. Inch Units

3M™ Blenderm™ Tape 1525-0 ½ in. x 5 yd. 5 1525-1 1 in. x 5 yd. 10 1525-2 2 in. x 5 yd. 20

3M™ Cloth Adhesive Tape 2950-0 ½ in. x 10 yd. 10 2950-1 1 in. x 10 yd. 20 2950-2 2 in. x 10 yd. 40 2950-3 3 in. x 10 yd. 60

3M™ Durapore™ Tape 1538-0 ½ in. x 10 yd. 10

1538-1 1 in. x 10 yd. 20 1538-2 2 in. x 10 yd. 40 1538-3 3 in. x 10 yd. 60

Single Use Rolls: 1538S-1 1 in. x 1-1/2 yd. 3 1538S-2 2 in. x 1-1/2 yd. 6

3M™ Kind Removal Silicone Tape 2770-1 1 in. x 5.5 yd. 11 2770-2 2 in. x 5.5 yd. 22 2775-0 .75 in. x 5.5 yd. 22 2775-1 1 in. x 5.5 yd. 8 2775-2 2 in. x 5.5 yd. 22

Single Use Rolls: 2770S-1 1 in. x 1.5 yd. 3 2770S-2 2 in. x 1.5 yd. 6

3M™ Medipore™ H Soft Cloth Tape 2861 1 in. x 10 yd. 20

2862 2 in. x 10 yd. 40 2863 3 in. x 10 yd. 60 2864 4 in. x 10 yd. 80 2866 6 in. x 10 yd. 120 2868 8 in. x 10 yd. 160

Two Yard Rolls: 2862S 2 in. x 2 yd. 8 2864S 4 in. x 2 yd. 16 2866S 6 in. x 2 yd. 24

3M™ Medipore™ Soft Cloth Tape 2961 1 in. x 10 yd. 20

2962 2 in. x 10 yd. 40 2963 3 in. x 10 yd. 60 2964 4 in. x 10 yd. 80 2966 6 in. x 10 yd. 120 2968 8 in. x 10 yd. 160

Two Yard Rolls: 2962S 2 in. x 2 yd. 8 2964S 4 in. x 2 yd. 16 2966S 6 in. x 2 yd. 24

3M™ Microfoam™ Tape 1528-1 1 in. x 5-1/2 yd. 11

1528-2 2 in. x 5-1/2 yd. 22 1528-3 3 in. x 5-1/2 yd. 33 1528-4 4 in. x 5-1/2 yd. 44

NOTE: Please see Disclaimer information on page one. 16

Medical Tapes —Conversion to 18 Square Inch Units (continued)

3M™ Micropore™ Tape

Standard: 1530-0 ½ in. x 10 yd. 10 1530-1 1 in. x 10 yd. 20 1530-2 2 in. x 10 yd. 40 1530-3 3 in. x 10 yd. 60

Single Use Rolls: 1530S-1 1 in. x 1-1/2 yd. 3 1530S-2 2 in. x 1-1/2 yd. 6

Tan: 1533-0 ½ in. x 10 yd. 10 1533-1 1 in. x 10 yd. 20 1533-2 2 in. x 10 yd. 40

Dispenser Pack: 1535-0 1/2 in. x 10 yd. 10 1535-1 1 in. x 10 yd. 20 1535-2 2 in. x 10 yd. 40 1535-3 3 in. x 10 yd. 60

3M™ Transpore™ Tape 1527-0 ½ in. x 10 yd. 10

1527-1 1 in. x 10 yd. 20 1527-2 2 in. x 10 yd. 40 1527-3 3 in. x 10 yd. 60

Single Use Rolls: 1527S-1 1 in. x 1-1/2 yd. 3 1527S-2 2 in. x 1-1/2 yd. 6

3M™ Transpore™ White Tape 1534-0 1/2 in. x 10 yd. 10

1534-1 1 in. x 10 yd. 20 1534-2 2 in. x 10 yd. 40 1534-3 3 in. x 10 yd. 60

Single Use Rolls: 1534S-1 1 in. x 1-1/2 yd. 3 1534S-2 2 in. x 1-1/2 yd. 6

3M™ Universal Cloth Adhesive Tape 881-1 1 in. x 10 yd. 20

881-2 2 in. x 10 yd. 40 881-3 3 in. x 10 yd. 60

Note:

This chart does not recommend how or how much of a particular medical tape should be billed to Medicare or other health care insurers. All billing of products to the patient’s health insurance program should accurately reflect the actual product and amount that was clinically necessary to treat the patient’s condition and the amount actually provided to the patient.

Critical & Chronic Care Solutions Division 3M Health Care 2510 Conway Avenue St. Paul, MN 55144-1000 USA 1-800-228-3957 www.3M.com/healthcare

3M, Blenderm, Cavilon, Coban, Durapore, Medipore, Microfoam, Micropore, Nexcare, Reston, Tegaderm and Transpore are trademarks of 3M Company. Please recycle. Printed in USA. © 3M 2004, 2015. All rights reserved. 70-2009-6368-7