Showing codes Q4120 (Matristem burn matrix, per square centimeter) — Q4151 (Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure))

Q4120 - Matristem burn matrix
Long description: Matristem burn matrix, per square centimeter
Code added date: 20110101.
Code effective date: 20170101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4121 - Theraskin
Long description: Theraskin, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20110101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4122 - Dermacell, awm, porous sq cm
Long description: Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4123 - Alloskin
Long description: Alloskin rt, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4124 - Oasis tri-layer wound matrix
Long description: Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4125 - Arthroflex
Long description: Arthroflex, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4126 - Memoderm/derma/tranz/integup
Long description: Memoderm, dermaspan, tranzgraft or integuply, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4127 - Talymed
Long description: Talymed, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4128 - Flexhd/allopatchhd/sq cm
Long description: Flex hd, or allopatch hd, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4129 - Unite biomatrix
Long description: Unite biomatrix, per square centimeter
Code added date: 20120101.
Code effective date: 20170101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4130 - Strattice tm
Long description: Strattice tm, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20120101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4131 - Epifix or epicord
Long description: Epifix or epicord, per square centimeter
Code added date: 20130101.
Code effective date: 20190101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4132 - Grafix core, grafixpl core
Long description: Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20130101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4133 - Grafix stravix prime pl sqcm
Long description: Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20130101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4134 - Hmatrix
Long description: Hmatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20130101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4135 - Mediskin
Long description: Mediskin, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20130101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4136 - Ezderm
Long description: Ez-derm, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20130101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4137 - Amnioexcel biodexcel 1sq cm
Long description: Amnioexcel, amnioexcel plus or biodexcel, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4138 - Biodfence dryflex, 1cm
Long description: Biodfence dryflex, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4139 - Amnio or biodmatrix, inj 1cc
Long description: Amniomatrix or biodmatrix, injectable, 1 cc
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4140 - Biodfence 1cm
Long description: Biodfence, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4141 - Alloskin ac, 1 cm
Long description: Alloskin ac, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4142 - Xcm biologic tiss matrix 1cm
Long description: Xcm biologic tissue matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4143 - Repriza, 1cm
Long description: Repriza, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4145 - Epifix, inj, 1mg
Long description: Epifix, injectable, 1 mg
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4146 - Tensix, 1cm
Long description: Tensix, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4147 - Architect ecm px fx 1 sq cm
Long description: Architect, architect px, or architect fx, extracellular matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4148 - Neox neox rt or clarix cord
Long description: Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4149 - Excellagen, 0.1 cc
Long description: Excellagen, 0.1 cc
Code added date: 20140101.
Code effective date: 20260101.
Pricing Indicator Code(s): 13 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4150 - Allowrap ds or dry 1 sq cm
Long description: Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20150101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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Q4151 - Amnioband, guardian 1 sq cm
Long description: Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure)
Code added date: 20150101.
Code effective date: 20260101.
Pricing Indicator Code(s): 11 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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