Summary & Overview
HCPCS Q4112: Cymetra injectable, 1 cc
HCPCS Level II code Q4112 denotes a 1 cc unit of Cymetra, an injectable dermal matrix product used for soft-tissue augmentation and reconstructive purposes. Nationally, this code matters because it standardizes reporting and unitization for billing of injectable dermal matrices across outpatient and ambulatory settings, which affects coverage determination, claims processing, and clinical documentation for reconstructive and augmentation procedures. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what Q4112 represents clinically and operationally, summaries of payer coverage considerations, and typical service contexts where the code is used. The publication also outlines comparative benchmarks and policy-relevant updates that influence coding practice and reimbursement pathways. Additionally, clinical context is summarized to clarify when a unit-based injectable dermal matrix code is applied and how units relate to procedural use. Data not available in the input is noted where applicable, including specific payer policies, diagnosis pairings, and related codes.
Billing Code Overview
HCPCS Level II code Q4112 describes Cymetra, injectable, 1 cc. This code represents a single cubic centimeter unit of an injectable dermal matrix product used in soft-tissue augmentation and reconstructive procedures. The service type is an injectable biologic/dermal filler used for tissue augmentation or reconstruction. The typical site of service is outpatient clinical settings where injectable procedures are performed, such as ambulatory surgical centers, hospital outpatient departments, and physician offices.
Clinical & Coding Specifications
Clinical Context
A 52-year-old female presents to an outpatient dermatologic/plastic surgery clinic for correction of facial contour irregularities and soft tissue defects following scar revision and fat loss after trauma. The clinician selects Q4112 (Cymetra, injectable, 1 cc) as an injectable human acellular dermal matrix used to provide soft-tissue bulk and support during office-based soft tissue augmentation. The typical workflow: pre-procedure evaluation including history and focused exam, photography, informed consent, and marking of treatment sites; local anesthetic or tumescent infiltration as needed; aseptic preparation; injection of Q4112 into subcutaneous and/or intradermal planes using sterile syringes and appropriate needles/cannulae; post-injection molding and observation for immediate adverse effects. Procedure documentation includes product lot number and volume administered, site(s) treated, technique, anesthesia, and any immediate complications. Typical sites of service are ambulatory surgical centers and outpatient clinic/procedure rooms for dermatology or plastic surgery practices.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Professional component | Use when reporting only the physician's professional service for the procedure when a separate technical component exists. |