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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q4244-procenta-200mg-medication-supply
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    HCPCS Level II Q4244: Procenta, 200 mg

    HCPCS Level II code Q4244 represents Procenta supplied in 200 mg increments, a specified drug billing code used for reporting administration or supply of this medication; the service is medication dispensing/infusion and the typical site of service is outpatient infusion or clinic-based administration (or other facility outpatient settings) where injectable biologic or specialty drugs are provided.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a documented chronic inflammatory or autoimmune condition (for example, rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis) who requires treatment with an interleukin-targeting biologic supplied as a vial of Procenta (per 200 mg). The clinical workflow begins with a specialty clinic or infusion/ambulatory infusion center visit where a prescribing rheumatologist or specialty nurse confirms diagnosis, documents prior therapies and labs, obtains informed consent, and orders the medication. Pharmacy verifies dose and prepares the 200 mg vial under sterile conditions. The patient may receive the product as an outpatient injection or supervised infusion depending on formulation and payer rules. Observation for infusion- or injection-related reactions follows administration, and the encounter is documented with medication lot number, route, dose, administration site, and any immediate adverse events. Billing uses HCPCS Level II code Q4244 with appropriate modifiers to reflect unusual services, payer-required circumstances, or provider/supplier arrangements.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96372Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)Commonly used when Procenta is administered as a subcutaneous injection in clinic.
    96413Chemotherapy administration, intravenous infusion technique, up to 1 hourUsed if the biologic is administered via IV infusion requiring timed infusion service reporting.
    96415Each additional hour of infusion, chemotherapy administrationUsed for prolonged infusions beyond the initial hour when an extended infusion is clinically required.
    99070Supplies and materials (non-covered) used for patient careUsed to report administration supplies when payer requires separate reporting.
    96361Intravenous infusion, hydration; initial, up to 1 hourMay be reported when IV hydration is provided in conjunction with infusion of the biologic.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    164W00000XLicensed Practical NurseAn individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required f…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    374U00000XHome Health AideA person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.
    2084P2900XPain Medicine (Psychiatry & Neurology) PhysicianA neurologist, child neurologists or psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experie…
    221700000XArt Therapist(1) An individual who uses art to achieve the therapeutic goals of symptom relief, emotional integration, and recovery from or adjustment to illness o…
    163WC0400XCase Management Registered NurseNursing Service Providers · Registered Nurse

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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