Summary & Overview
HCPCS Q4148: Neox/Clarix Cord Biologic, Per Square Centimeter
HCPCS Level II code Q4148 designates per-square-centimeter billing for biologic cord products marketed as Neox cord 1k, Neox cord RT, or Clarix cord 1k. As an add-on code, it is billed in addition to a primary surgical or wound-care procedure and priced by the area treated. Nationally, this code matters because it standardizes reporting and reimbursement for specialized tissue-derived products used in complex wound management and soft-tissue reconstruction, affecting hospital outpatient, ASC, and clinic billing workflows.
Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, typical sites of service, and which payers are commonly involved in coverage decisions. The publication outlines expected benchmarks for utilization and reimbursement, summarizes relevant policy considerations for add-on biologic products, and provides clinical context about when per-square-centimeter grafts are used in practice. If specific payer policy details, taxonomies, or ICD-10 linkage are required, the report indicates whether those data elements are provided or are not available in the input.
Billing Code Overview
HCPCS Level II code Q4148 describes an add-on, per square centimeter product used in human tissue or wound management identified as Neox cord 1k, Neox cord RT, or Clarix cord 1k. This code represents a biologic/amnion-derived or tissue-derived graft material supplied and billed in addition to a primary procedure, with billing based on the treated area in square centimeters.
Service Type: Biologic graft / tissue-derived wound care product
Typical Site of Service: Hospital outpatient departments, ambulatory surgical centers, wound care clinics, and physician offices where advanced wound or soft-tissue reconstruction procedures are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–70-year-old adult presenting to an outpatient wound care clinic or an ambulatory surgical center with a chronic, nonhealing soft-tissue wound (for example, a diabetic foot ulcer, venous stasis ulcer, or complex surgical wound dehiscence) that has failed conservative management. The treating clinician (often a wound care specialist, plastic surgeon, or podiatrist) evaluates the wound, confirms adequate vascular supply or optimizes perfusion, performs debridement of necrotic tissue, and determines that an advanced biologic graft derived from umbilical cord matrix (e.g., Neox Cord 1K, Neox Cord RT, Clarix Cord 1K) is indicated to promote healing.
The product represented by Q4148 is billed as an add-on charge per square centimeter of graft placed. Typical workflow: wound assessment and measurement, sharp or surgical debridement, hemostasis, irrigation, application of the cord-derived graft sized to the wound bed, securement and dressings, and post-procedure dressing changes and follow-up visits. The service is commonly provided in outpatient wound centers, ambulatory surgery centers, hospital outpatient departments, or specialty clinics capable of performing minor outpatient procedures and biologic graft application. Patient education about immobilization, offloading (for plantar foot wounds), and infection signs is provided, with scheduled follow-up for graft take assessment and dressing changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |