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This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.
Q4101 can be used to bill Apligraf. One unit of this code covers a square centimeter. Below are the description and billing guidelines for this HCPCS code.
1. What Is HCPCS Code Q4101?
Q4101 covers each square centimeter of Apligraf. This is a skin substitute providers use to treat diabetic foot and venous leg ulcers.
2. What Is Apligraf?
Apligraf is a skin substitute that providers create from healthy human skin.
It is a bilayered, or two-layered, product consisting of a protective outer layer and an inner layer of cells surrounded by collagen. This fibrous protein is the main component of connective tissue.
Apligraf does not contain hair follicles, sweat glands, or blood vessels.
3. Description
The HCPCS book describes code Q4101 as follows: “Apligraf, per square centimeter.”
4. Procedure
The provider places the skin substitute directly on the wound and wraps the injured area with a nonadhesive dressing to keep it in place.
Billing Guidelines
Providers use this skin substitute for patients with diabetic ulcers and venous leg ulcers that do not heal with routine therapies of ointments and dressings.
For the application of skin substitutes and replacements, see CPT 15271, CPT 15272, CPT 15273, and CPT 15274.
Q4101 is often considered not medically necessary. Check the payers’ guidelines to see if this code can be reimbursed.
Resources
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56696&ver=15&bc=0
This content may be outdated
This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.
