Q42 — HCPCS Level II Codes

Q4200 Skin te, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4201 Matrion, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4202 Keroxx (2.5g/cc), 1cc billable
Q4203 Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4204 Xwrap, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4205 Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4206 Fluid flow or fluid gf, 1 cc billable
Q4208 Novafix, per square cenitmeter (add-on, list separately in addition to primary procedure) billable
Q4209 Surgraft, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4211 Amnion bio or axobiomembrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4212 Allogen, per cc billable
Q4213 Ascent, 0.5 mg billable
Q4214 Cellesta cord, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4215 Axolotl ambient or axolotl cryo, 0.1 mg billable
Q4216 Artacent cord, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4217 Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4218 Surgicord, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4219 Surgigraft-dual, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4220 Bellacell hd or surederm, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4221 Amniowrap2, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4222 Progenamatrix, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4224 Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4225 Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4226 Myown skin, includes harvesting and preparation procedures, per square centimeter billable
Q4227 Amniocore, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4229 Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4230 Cogenex flowable amnion, per 0.5 cc billable
Q4232 Corplex, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4233 Surfactor or nudyn, per 0.5 cc billable
Q4234 Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4235 Amniorepair or altiply, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4236 Carepatch, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4237 Cryo-cord, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4238 Derm-maxx, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4239 Amnio-maxx or amnio-maxx lite, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4240 Corecyte, for topical use only, per 0.5 cc billable
Q4241 Polycyte, for topical use only, per 0.5 cc billable
Q4242 Amniocyte plus, per 0.5 cc billable
Q4245 Amniotext, per cc billable
Q4246 Coretext or protext, per cc billable
Q4247 Amniotext patch, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4248 Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4249 Amniply, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4250 Amnioamp-mp, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4251 Vim, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4252 Vendaje, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4253 Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4254 Novafix dl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4255 Reguard, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4256 Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4257 Relese, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4258 Enverse, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4259 Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4260 Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4261 Tag, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4262 Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4263 Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4264 Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4265 Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4266 Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4267 Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4268 Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4269 Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4270 Complete sl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4271 Complete ft, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4272 Esano a, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4273 Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4274 Esano ac, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4275 Esano aca, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4276 Orion, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4278 Epieffect, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4279 Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4280 Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4281 Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4282 Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4283 Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4284 Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4285 Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4286 Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4287 Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4288 Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4289 Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4290 Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4291 Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4292 Lamellas, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4293 Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4294 Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4295 Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4296 Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4297 Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4298 Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure) billable
Q4299 Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure) billable