Summary & Overview
HCPCS Q4140: Biodfence per Square Centimeter, Surgical Biologic Supply
HCPCS Level II code Q4140 denotes Biodfence billed per square centimeter as an add-on supply item reported in addition to a primary surgical procedure. This code matters nationally because it standardizes reporting for a surface-area–priced biologic barrier used in surgical repair and wound management, enabling consistent tracking of utilization and payments for implantable biologic materials. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what the code represents clinically and operationally, which payers commonly cover the item, and where this code appears on the service line (as an add-on implant/supply billed by area). The publication also summarizes common modifiers associated with reporting, typical sites of service such as hospital operating rooms and ambulatory surgical centers, and guidance on documentation elements tied to per-square-centimeter billing. Policy updates, billing benchmarks, and clinical context sections provide national-level insights into coding practice, payment policy drivers, and considerations for documentation and claims processing. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4140 describes Biodfence billed per square centimeter as an add-on supply item that is reported separately in addition to a primary procedure. The service represents a biologic barrier material used during surgical procedures to provide tissue separation or to support surgical repair, billed based on the surface area in square centimeters.
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Service type: Surgical biologic implant/supply
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Typical site of service: Hospital operating room, ambulatory surgical center, or other procedural settings where surgical implantation or wound repair is performed.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult undergoing abdominal wall hernia repair or musculoskeletal soft-tissue reconstruction in which an adjunctive biologic barrier graft is required to reinforce tissue, separate planes, or protect against adhesion formation. The procedure for product Q4140 (Biodfence, per square centimeter) is billed as an add-on supply in conjunction with a primary surgical procedure. The clinical workflow begins with preoperative assessment by a general surgeon or plastic surgeon who documents the need for a biologic barrier based on contamination risk, tissue quality, or anticipated mesh exposure. Intraoperatively, after completion of the primary repair (for example, open ventral hernia repair, abdominal wall reconstruction, or complex wound closure), the surgeon sizes and trims the Biodfence graft to cover the defect or to serve as an interface between implantable mesh and visceral contents. The product is measured in square centimeters for billing. The operative report must reference the primary procedure, the area (cm2) of Biodfence used, and clinical justification for the biologic barrier (e.g., contamination, proximity to bowel, recurrent hernia). Typical sites of service are inpatient hospital operating room, outpatient hospital outpatient surgery center, and ambulatory surgical center. Common patient scenarios include contaminated or potentially contaminated abdominal wall repairs, complex soft-tissue reconstructions after oncologic resection, and revision surgeries where native tissue is insufficient for primary closure.
Coding Specifications
| Modifier | Description | When to Use |
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