Summary & Overview
HCPCS Q4119: Matristem Wound Matrix, Per Square Centimeter
HCPCS Level II code Q4119 denotes Matristem wound matrix, billed per square centimeter, an advanced biologic product used in the treatment of chronic, non-healing, or complex wounds. This product-level code is important nationally because it standardizes reporting for a specific wound matrix, enabling consistent billing, utilization tracking, and policy development for advanced wound therapies. Payers and providers use such codes to determine coverage, prior authorization requirements, and clinical criteria for use.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how Q4119 is positioned within wound care service lines, common sites of service, and the clinical contexts in which a Matristem wound matrix is applied. The publication also summarizes benchmarking topics and implementation concerns that influence payer coverage decisions and claims processing for advanced wound products.
This piece provides national-level context on coding and clinical application, what stakeholders typically review when evaluating product use, and where to look for payer-specific coverage policies. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4119 represents Matristem wound matrix, billed per square centimeter. This code describes a biologic wound matrix product used in the management of complex or non-healing wounds.
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Service type: Wound care product application/implantation
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Typical site of service: Outpatient wound care clinics, hospital outpatient departments, long-term care facilities, and other settings where advanced wound care products are applied
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Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult with a chronic, non-healing lower-extremity wound (for example, a diabetic foot ulcer or venous stasis ulcer) that has failed standard care such as debridement, offloading, compression, infection control, and advanced dressings. The wound care specialist (podiatrist, vascular surgeon, wound care physician, or advanced practice clinician) evaluates the wound in an outpatient wound clinic or hospital-based wound center. After assessment including measurement, debridement, and optimization of perfusion and infection control, the clinician selects an amniotic-derived soft tissue matrix product, billed as Q4119 per square centimeter, to be applied to the wound bed to promote wound healing.
Workflow steps typically include wound measurement and documentation, photographic documentation, preparation of the wound bed with sharp or enzymatic debridement, irrigation, application of Q4119 (Matristem wound matrix) sized to the wound area, securement with appropriate dressings or negative-pressure wound therapy if indicated, and scheduling follow-up visits for reapplication or assessment. The typical site of service is an outpatient wound clinic, physician office, ambulatory surgery center, or inpatient hospital setting when applied as part of complex wound management. Patients commonly have comorbidities such as diabetes mellitus, peripheral vascular disease, or venous insufficiency that contribute to chronic wound formation.
Coding Specifications
| Modifier | Description | When to Use |
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