Summary & Overview
HCPCS Level II Q4171: Interfyl, 1 mg
HCPCS Level II code Q4171 denotes Interfyl, 1 mg, a biologic product used in clinical settings where injectable biologic therapies are administered. National attention to biologic drug billing has grown due to high per-dose costs and evolving coverage policies; accurate coding of products like Interfyl affects clinical billing workflows and payer adjudication. Key national payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of what Q4171 represents, the service type and typical site of service, and which major payers are relevant for coverage considerations. The publication summarizes reimbursement and billing benchmarks, common modifier usage, and practical clinical context for documentation and claims submission. It also highlights policy updates and payer guidance that commonly affect biologic product billing, as well as areas where data was not provided. This resource is intended to help revenue cycle, coding, and clinical teams understand how HCPCS Level II code Q4171 is used in practice and what topics to review when managing claims for Interfyl, 1 mg.
Billing Code Overview
HCPCS Level II code Q4171 describes Interfyl, 1 mg, a biologic product supplied for therapeutic use. The service type for this code is biologic drug administration, and the typical site of service is outpatient infusion or ambulatory clinic where injectable biologic therapies are administered.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a chronic, non-healing diabetic foot ulcer or other complex cutaneous wound that requires a biologic wound matrix for soft tissue regeneration. The patient commonly presents to a wound care clinic or outpatient surgery center after failed conservative therapy (offloading, debridement, topical agents) and may have comorbid diabetes mellitus, peripheral vascular disease, or prior local infection. The clinical workflow begins with evaluation by a wound care specialist (podiatry, plastic surgery, or wound care medicine): assessment of wound size, depth, perfusion, and infection status; sharp or surgical debridement of necrotic tissue; optimization of glycemic control and vascular status; and, when appropriate, application of an allogeneic placental-derived product such as Interfyl (Q4171, Interfyl, 1 mg). The product is applied to the prepared wound bed under sterile technique, secured with appropriate secondary dressings, and the patient is scheduled for serial dressing changes and follow-up visits to monitor integration, re-epithelialization, and signs of complication. Typical sites of service are outpatient wound care clinics, ambulatory surgical centers, or hospital outpatient departments. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |