Summary & Overview
HCPCS Q4105: Integra Dermal Regeneration Template, Per Square Centimeter
HCPCS Level II code Q4105 identifies billing for the Integra dermal regeneration template or Integra OmniGraft dermal regeneration matrix, billed per square centimeter as an add-on supply in addition to a primary procedure. This code is used when clinicians apply a biologic dermal substitute during reconstructive or wound management procedures to support dermal regeneration and improve healing outcomes. Nationally, use of dermal regeneration matrices affects hospital and ambulatory surgical supply costs and can influence procedure choice for complex wounds and burn care.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and common sites of service, followed by benchmarking and coverage themes. The publication presents reimbursement benchmarks, typical coding considerations for add-on biologic supplies, and relevant payer coverage patterns where available. It also outlines clinical scenarios in which Q4105 is typically reported, clarifies its add-on status relative to primary procedures, and highlights points that affect billing practice nationally. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code Q4105 describes an Integra dermal regeneration template (DRT) or Integra OmniGraft dermal regeneration matrix billed per square centimeter as an add-on supply to be listed separately in addition to a primary procedure. The service type is dermal regeneration matrix application / biological skin substitute. The typical site of service is operating room or outpatient surgical facility where wound reconstruction, grafting, or complex soft-tissue repair is performed. If additional clinical or billing details are required, Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a full-thickness lower extremity wound following excision of a chronic nonhealing ulcer is scheduled for application of a dermal regeneration template. The patient has previously undergone debridement and wound bed preparation in the operative suite. During the same operative session, the surgical team applies an Integra dermal regeneration template (Integra DRT / Integra Omnigraft) to the prepared wound bed, measured and billed per square centimeter using Q4105 as an add-on supply code in addition to the primary surgical procedure. The typical workflow includes: preoperative assessment and optimization of comorbidities (for example, diabetes and peripheral vascular disease), intraoperative debridement or excision (documented as the primary surgical code), placement and securing of the dermal regeneration matrix over the wound (dimensions recorded in square centimeters), dressing application, and detailed operative documentation of the product name, size, and square centimeters used. Postoperative care includes scheduled dressing changes, monitoring for graft take and infection, and documentation of any additional procedures (for example, split-thickness skin grafting at a later date). Typical site of service is an ambulatory surgery center or hospital operating room. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |