Summary & Overview
HCPCS Q4245: Amniotext, per cc
HCPCS Level II code Q4245 denotes billing for amniotic-derived biologic material billed by volume: Amniotext, per cc. As an HCPCS Level II supply code, Q4245 identifies a specific biologic product used in wound care and regenerative procedures where amniotic tissue is applied or implanted. Nationally, accurate coding for biologic products like amniotext affects coverage determinations, prior authorization workflows, and payment consistency across payers.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for amniotic products, guidance on typical sites of service where Q4245 is used, and a summary of payer coverage considerations and common billing modifiers associated with this type of HCPCS Level II supply. The publication provides benchmarks and coding practice notes relevant to administrative, clinical, and revenue cycle stakeholders, and flags where payer-specific coverage policy or documentation requirements commonly influence claim acceptance and reimbursement.
Billing Code Overview
HCPCS Level II code Q4245 represents Amniotext, per cc. The service involves the provision of amniotic-derived biologic material measured and billed by volume (per cubic centimeter). This product is typically used in wound care, soft tissue repair, or regenerative medicine applications and is supplied as a biologic implant or graft.
-
Service type: Biologic amniotic product administration/supply
-
Typical site of service: Outpatient clinics, hospital outpatient departments, wound care centers, and ambulatory surgical centers
Clinical & Coding Specifications
Clinical Context
A typical patient is a pregnant woman presenting in the outpatient maternal-fetal medicine clinic or labor and delivery unit for assessment of amniotic fluid volume and analysis. The procedure involves collection and provision of amniotic fluid-derived product billed as Q4245 (Amniotext, per cc). Clinical workflow: ultrasound-guided amniocentesis or retrieval of amniotic fluid during cesarean delivery or therapeutic amnioinfusion; collected fluid is processed or aliquoted for preparation of amniotext product, labeled by volume (cc), stored and delivered to the ordering clinician or facility. Indications include oligohydramnios requiring volume restoration, preparation of biologic amniotic allograft material for wound or surgical use, fetal genetic testing sample handling, or intrauterine therapeutic applications. Typical sites of service are outpatient physician offices (maternal-fetal medicine), ambulatory surgery centers, hospital outpatient departments, and inpatient labor and delivery suites. The typical patient scenario: a 32-year-old G2P1 at 34 weeks with documented oligohydramnios on ultrasound undergoing ultrasound-guided amniocentesis for therapeutic instillation and collection of amniotic fluid; the collected fluid is processed to produce amniotext and billed per cc using Q4245 to cover the product volume provided to the treating team or facility.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |