Summary & Overview
HCPCS Q4103: Oasis Burn Matrix, Per Square Centimeter
HCPCS Level II code Q4103 identifies an Oasis burn matrix billed per square centimeter as an add-on item in burn and wound management. This code matters nationally because it standardizes reporting for a commonly used biologic matrix product in acute and outpatient burn care, informing billing consistency and program coverage decisions across payers. The analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for use of the product, typical sites of service where the matrix is supplied (hospital outpatient departments, burn centers, and wound clinics), and the implications of add-on per-area billing for claims workflows. The publication summarizes available benchmarks and coverage patterns, highlights policy and coding considerations relevant to add-on HCPCS reporting, and outlines typical modifier use and billing mechanics where applicable. Where payer-specific policies differ, the report flags variability in coverage terms and documentation expectations. Data not available in the input will be identified as such rather than inferred.
Billing Code Overview
HCPCS Level II code Q4103 describes an Oasis burn matrix, billed per square centimeter as an add-on item to be listed separately in addition to a primary procedure. The service represents a specialized topical or dermal matrix product used in the management of burn wounds, measured and billed by surface area.
Service Type: Wound care / Burn matrix product
Typical Site of Service: Hospital outpatient department, burn center, outpatient wound clinic, or other acute care settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with a partial-thickness or full-thickness burn to a focal area of skin presents to a hospital outpatient wound clinic or acute care operating room for definitive wound management. After initial debridement and preparation of the wound bed, the clinician applies an Oasis burn matrix as an adjunct to surgical or non-surgical burn care to promote granulation and re-epithelialization. The service is billed in addition to the primary procedure (for example, excision and grafting or topical wound care) and is reported per square centimeter using Q4103 as an add-on code. Typical workflow: initial evaluation and stabilization, wound debridement (sharp or enzymatic), measurement of treated surface area in square centimeters, application of the Oasis burn matrix to the prepared wound, dressing placement, and documentation of product quantity (cm2), indication, and concurrent primary procedure. Common sites of service include hospital inpatient or outpatient operating rooms, hospital outpatient wound clinics, and outpatient ambulatory surgery centers where burn excision, grafting, or advanced wound therapies are performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to apply the matrix is substantially greater than typical due to complexity or additional time beyond the primary procedure. |