Summary & Overview
HCPCS Q4114: Integra Flowable Wound Matrix, Injectable, 1 cc
HCPCS Level II code Q4114 designates a 1 cc vial of Integra flowable wound matrix, an injectable biologic used to support wound healing and tissue regeneration. The code is used to bill for the product rather than a procedure and is relevant across outpatient wound care settings, ambulatory surgical centers, and hospital outpatient departments. Nationally, accurate coding for injectable wound matrices affects product tracking, coverage decisions, and payment consistency for advanced wound care therapies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical role of the product, typical sites of service, and which payers are commonly involved in coverage determinations. The publication summarizes benchmarking and utilization context where available, highlights common billing modifiers used with injectable biologics, and outlines policy and coverage considerations that influence reimbursement and prior authorization practices. It also provides clinical context for when a flowable wound matrix may be used and notes where input data was not provided.
This summary is intended for national audiences including clinicians, billing professionals, and policy analysts seeking a clear, policy-focused briefing on HCPCS Level II code Q4114 and its role in advanced wound care billing and coverage.
Billing Code Overview
HCPCS Level II code Q4114 describes Integra flowable wound matrix, injectable, 1 cc. This code represents a sterile, injectable, flowable wound matrix product intended for use in wound care management to support tissue regeneration and healing.
Service type: Injectable wound matrix / biologic for wound management
Typical site of service: Outpatient wound care clinics, hospital outpatient departments, ambulatory surgical centers, and other settings where injectable biologics are administered for wound treatment.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a chronic non-healing lower-extremity wound (for example, a diabetic foot ulcer or venous stasis ulcer) that has failed conservative care including local wound care, debridement, offloading, and compression. In outpatient wound care clinic or ambulatory surgical center settings, after sharp or surgical debridement and hemostasis, the clinician prepares the wound bed and injects Q4114 Integra flowable wound matrix, injectable, 1 cc, into wound pockets, undermined areas, or irregular defects to provide a collagen scaffold that supports cellular infiltration and tissue regeneration. Procedural workflow typically includes pre-procedure assessment (vascular status, infection control), wound measurement and photography, informed consent, local anesthesia or conscious sedation as needed, irrigation and debridement, placement of the flowable matrix Q4114, appropriate dressing, and documentation including product lot number and quantity used. Typical sites of service are outpatient wound clinics, physician offices, ambulatory surgical centers, and inpatient hospital wound care units when complex care is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; default billing | Use when no special circumstances or modifiers apply to the service. |