Summary & Overview
HCPCS Q4228: Bionextpatch, per square centimeter
HCPCS Level II code Q4228 identifies the Bionextpatch billed per square centimeter, a patch-based medical product used for topical or transdermal therapeutic purposes. Nationally, this code matters for supply reimbursement and tracking use of area-based patch products in outpatient and ambulatory care settings, including wound care and dermatology.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coverage patterns and the practical billing context for Q4228, including common settings where the product is administered and considerations for area-based billing. The publication outlines benchmarks for utilization and reimbursement where available, references relevant payer coverage tendencies, and summarizes the clinical context in which Bionextpatch is typically applied.
The report delivers actionable reference material for revenue cycle, coding, and clinical teams: a clear description of the code and its service implications, payer coverage landscape, common modifiers used with area-based supplies, and notes on documentation and billing workflows. Data not provided in the input are noted as unavailable.
Billing Code Overview
HCPCS Level II code Q4228 describes Bionextpatch, billed per square centimeter. This code represents a patch-based biomaterial product intended for topical or transdermal application, with billing calculated by the surface area of product used (per cm²).
Service type: Medical supply/device application or topical therapeutic product
Typical site of service: Outpatient clinics, physician offices, ambulatory care centers, and outpatient wound care or dermatology settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a non-healing or complex cutaneous wound (for example, a diabetic foot ulcer, venous stasis ulcer, or pressure ulcer) requiring application of a biologic skin substitute patch measured and billed by surface area. In clinic or outpatient wound-care center, the provider evaluates the wound, performs cleansing and debridement as indicated, measures wound area in square centimeters, and selects the Bionextpatch sized to cover the defect. The patch is applied to the prepared wound bed, secured per manufacturer instructions, and the site is dressed. Follow-up visits occur within 1–2 weeks to assess graft take, perform additional dressing changes, and determine need for repeat applications. Typical personnel include a wound-care physician or advanced practice provider, a registered nurse or wound-care specialist for application, and ancillary staff for supply handling and measurement documentation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to apply the patch is substantially greater than typical (extensive debridement, multiple adjacent wounds, prolonged time). |
23 |