Summary & Overview
HCPCS Level II Q4139: Injectable Amniomatrix or Biodmatrix, 1 cc
HCPCS Level II code Q4139 designates an injectable amniomatrix or biodmatrix, 1 cc, used as a small-volume biologic scaffold to support tissue repair and regeneration. Nationally, this code matters because it identifies the product for billing and coverage decisions in procedures that leverage biologic matrices, and it influences payer coverage, site-of-service considerations, and clinical documentation requirements.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical coverage considerations, common sites of service where this injectable is used, and the clinical context in which a 1 cc amniomatrix or biodmatrix is applied. The publication summarizes benchmark payment approaches, likely documentation expectations, and potential policy updates affecting biologic injectable products.
This analysis provides clinicians, billers, and policy stakeholders with concise benchmarks and policy context to inform billing practices and payer discussions. Data not available in the input is noted where applicable; the focus remains on the code definition, clinical use, and payer coverage landscape at a national level.
Billing Code Overview
HCPCS Level II code Q4139 describes an injectable amniomatrix or biodmatrix, 1 cc. This product is a biologic matrix intended for injection to support tissue repair or regeneration in procedures that require delivery of a small-volume biologic scaffold.
Service type: Injectable biologic matrix for tissue repair/regeneration
Typical site of service: Ambulatory surgical centers, hospital outpatient departments, physician office procedures, or other outpatient settings where injectable biologic products are administered
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a chronic, non-healing soft-tissue wound (for example, a diabetic foot ulcer, venous stasis ulcer, or pressure ulcer) evaluated in an outpatient wound care clinic or hospital-based clinic. The wound care team—often including a podiatrist, wound care physician, or plastic surgeon—performs standard wound assessment, debridement as needed, and cleansing. After preparing the wound bed and confirming suitability (adequate vascular supply, infection control), the clinician injects or places an amniotic-derived injectable matrix product (Q4139, amniomatrix or biodmatrix, injectable, 1 cc) into the wound base or surrounding soft tissue to support biological wound healing. The procedure typically occurs under local anesthesia in an office procedure room, ambulatory surgery center, or inpatient bedside when indicated. Documentation includes wound measurements, description of debridement, indication for biologic matrix, amount administered (number of Q4139 units), anesthesia used, and post-procedure wound care instructions. Follow-up visits document healing progress and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work required is substantially greater than usual for the injectable placement (extensive debridement or additional time). |