Summary & Overview
HCPCS Q4192: Restorigin, 1 cc
HCPCS Level II code Q4192 identifies Restorigin, a 1 cc injectable product used in outpatient clinical settings. As an HCPCS Level II code, Q4192 is used to report administration or supply of a specific drug or biologic unit distinct from procedure-oriented CPT codes. Nationally, accurate reporting of HCPCS drug codes like Q4192 matters for claims processing, inventory tracking, and reimbursement alignment across commercial and federal payers.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the product, typical sites of service, and the role of the HCPCS Level II code in billing workflows. The publication also summarizes available benchmarks and payer coverage considerations where provided, highlights common billing modifiers associated with injectable products, and notes gaps where input data was not available.
This summary is intended for national audiences including billing professionals, revenue cycle leaders, and clinicians seeking clarity on coding and reporting for injectable biologic products using HCPCS Level II codes.
Billing Code Overview
HCPCS Level II code Q4192 — Restorigin, 1 cc — denotes a specific injectable product delivered in a 1 cc unit. The service type associated with this code is an injectable biologic or pharmaceutical preparation administered by a clinician. The typical site of service for this product is outpatient clinic or physician office settings where injections or infusions are provided, including ambulatory infusion centers.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a focal musculoskeletal condition or dermatologic lesion for which a single 1 cc vial of a biologic product marketed as Q4192 (Restorigin, 1 cc) is supplied for injection. The patient often presents to an outpatient specialty clinic (orthopedics, sports medicine, pain management, or dermatology) with localized pain, tendinopathy, small cartilage defect, or a superficial soft tissue lesion where a targeted injection of a regenerative or biologic agent is clinically indicated. Evaluation includes history, focused musculoskeletal or dermatologic exam, and imaging review (plain radiographs, ultrasound, or MRI) when indicated.
The clinical workflow commonly proceeds as follows: pre-procedure evaluation and consent in clinic; verification of the biologic product Q4192 and dosage (1 cc) against the order; preparation of the injection in a procedure room under sterile technique; optional image guidance with ultrasound or fluoroscopy for accurate targeting; administration of the injection with post-procedure observation for immediate adverse reactions; and follow-up visits to assess clinical response and plan additional therapy if needed. Typical site of service is an outpatient ambulatory surgery center (ASC) or physician office-based procedure room. The procedure is coded as a HCPCS Level II supply code for billing the Restorigin product separately from professional service codes for the injection or image guidance.
Coding Specifications
| Modifier | Description | When to Use |
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