Summary & Overview
HCPCS Q4110: Primatrix Biologic Wound Matrix, Per Sq Cm
HCPCS Level II code Q4110 denotes Primatrix, a biologic wound matrix product billed per square centimeter as an add-on to a primary wound procedure. This code captures use of an adjunctive graft or matrix applied during wound care and surgical procedures to support tissue repair. Nationally, accurate reporting of add-on supply codes like Q4110 affects procedural documentation, product utilization tracking, and payer determinations for coverage and payment.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on what the code represents, the clinical contexts where the product is used, and which payers are commonly relevant for coverage considerations. The publication provides benchmarks and policy context where available, highlights typical sites of service for application, and outlines common billing practice considerations for adjunctive biologic products.
This summary offers clinicians, coding professionals, and policy analysts a national-level orientation to Q4110, helping stakeholders understand the code's clinical role, billing classification, and the payer landscape that affects authorization and claim adjudication decisions.
Billing Code Overview
HCPCS Level II code Q4110 represents Primatrix, billed per square centimeter as an add-on product. This code is used to report a biologic wound matrix product supplied in addition to a primary procedure for wound management.
Service type: Biologic wound matrix (adjunctive graft/matrix product)
Typical site of service: Outpatient clinics, hospital outpatient departments, wound care centers, and other ambulatory settings where surgical or procedural wound care is performed
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Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a full-thickness lower-extremity wound following surgical debridement for a chronic non-healing venous ulcer presents to an outpatient wound center for application of a biologic dermal matrix. The surgical team determines that the wound bed is well-vascularized and free of infection after sharp debridement and topical antimicrobial therapy. During the same encounter, the clinician applies a primary wound coverage or graft (for example, a split-thickness skin graft or flap) and uses a biologic matrix product, billed as Q4110 per square centimeter as an add-on material to support dermal regeneration beneath the primary procedure. Typical workflow includes wound measurement, photography, surgical debridement if needed, preparation of the matrix per manufacturer instructions, placement and fixation of the matrix concurrent with or immediately prior to the definitive coverage procedure, dressing application, and arrangement of follow-up wound checks in the clinic. Typical sites of service are outpatient wound centers, ambulatory surgery centers, hospital outpatient departments, or inpatient operating rooms when performed with a primary reconstructive procedure. Common patient scenarios include chronic non-healing venous or diabetic ulcers, traumatic soft-tissue loss requiring dermal substitute under a skin graft, and surgical excision of radiation or scar tissue with need for dermal augmentation prior to grafting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |