HCPCS Q4262: Dual Layer Impax Membrane, Per Square Centimeter - OpenPayer

Summary & Overview

HCPCS Q4262: Dual Layer Impax Membrane, Per Square Centimeter

HCPCS Level II code Q4262 represents a dual layer impax membrane, billed per square centimeter as an add-on supply in addition to a primary procedure. This code captures usage of a specialized membrane product used during surgical procedures for tissue repair or regeneration and is relevant to hospitals, ambulatory surgical centers, and other procedural sites. Nationally, accurate reporting of add-on supply codes like Q4262 matters for clinical documentation, device tracking, and claims processing because these codes affect reimbursement flows and procedural cost accounting.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the membrane, typical sites of service, common billing modifiers and coding considerations, and where available, payer-specific coverage patterns. The publication outlines benchmarks for add-on supply reporting, clarifies documentation expectations tied to product measurement (per square centimeter), and highlights policy elements that influence claim adjudication at national payers. Data not available in the input is noted where applicable, and the material is presented for national audiences seeking clarity on coding practice, billing implications, and administrative handling of add-on membrane supplies.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareQ4262HCPCS Level IIsurgical supplyadd-on codeimplantable membraneoperating roomambulatory surgical centerper square centimeterclaims coding

Billing Code Overview

HCPCS Level II code Q4262 describes a dual layer impax membrane, billed per square centimeter as an add-on item to be reported separately in addition to the primary procedure. The service type is a medical supply/implant adjunct, intended to be used intraoperatively or during a procedural intervention where a membrane product is required to support tissue repair or regeneration. The typical site of service is an ambulatory surgical center or hospital operating room, or other procedure-based settings where a primary surgical procedure is performed.

Clinical & Coding Specifications

Clinical Context

A patient presents for surgical repair of a cranial or craniofacial defect following tumor resection or traumatic injury. During the procedure the surgeon places a dual-layer impex membrane to promote guided tissue regeneration and dural repair. The membrane is sized intraoperatively and billed per square centimeter using the add-on HCPCS Level II code Q4262 in addition to the primary cranial or reconstructive procedure. Typical workflow: preoperative planning and imaging, general anesthesia, primary neurosurgical or plastic reconstructive procedure (e.g., craniotomy with dural repair or cranial bone grafting), intraoperative measurement of membrane area, documentation of membrane type and square centimeters used, attachment or placement technique documented, and postoperative monitoring in PACU with routine surgical follow-up.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no modifier applies to the service for standard billing.
`22`	Increased procedural services	Use when work required to place the membrane is substantially greater than typical and fully documented.

HCPCS Q4050: Cast Supplies, Unlisted Cast Materials

HCPCS-Q0508-VENTRICULAR-ASSIST-DEVICE-ACCESSORY

HCPCS Q0508: Miscellaneous Ventricular Assist Device Accessory

HCPCS-Q4303-COMPLETE-AA-PER-SQUARE-CENTIMETER-ADD-ON

HCPCS Q4303: Complete aa, Per Square Centimeter (Add-On)

HCPCS-Q0115-POST-COITAL-MUCUS-EXAMINATION

HCPCS Q0115: Post-coital Vaginal or Cervical Mucus Examination

HCPCS-Q9001-CHAPLAIN-ASSESSMENT-SPIRITUAL-CARE

HCPCS Q9001: Assessment by Chaplain Services

HCPCS-Q5158-DENOSUMAB-BIOSIMILAR-INJECTION-1MG

HCPCS Q5158: Denosumab-bnht (bomyntra/conexxence) Injection, 1 mg

HCPCS-Q4368-AMCHOTHICK-PER-SQUARE-CENTIMETER-ADD-ON

HCPCS Q4368: Amchothick, Per Square Centimeter (Add-on)

HCPCS-Q4010-SHORT-ARM-FIBERGLASS-CAST-ADULT

HCPCS Q4010: Cast Supplies, Short Arm Fiberglass

HCPCS-Q4182-TRANSCYTE-BIOLOGIC-SKIN-SUBSTITUTE-PER-CM2

HCPCS Q4182: Transcyte, Biologic Skin Substitute per cm2

HCPCS-Q4275-ESANO-ACA-PER-SQUARE-CENTIMETER-ADDON-MATERIAL

HCPCS Q4275: Esano aca, per square centimeter (add-on)

Showing 1–10 of 629

Taxonomy Code	Specialty	Notes
`2084P0800X`	Plastic Surgery	Performs craniofacial soft tissue reconstruction and membrane placement for dural or soft-tissue defects.
`207T00000X`	Neurosurgery	Performs craniotomy, dural repair, and places membranes for neuro-dural reconstruction.
`207K00000X`	Oral and Maxillofacial Surgery	Places membranes for craniofacial bone and soft tissue reconstruction in trauma and oncologic cases.
`207L00000X`	Otolaryngology (ENT)	Performs skull base and cranial base repairs where dural membranes may be used.
`363LP0800X`	Surgical Physician Assistant	Assists in membrane placement under surgeon supervision; documents intraoperative measurements.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S02.91XA`	Fracture of unspecified skull bone, initial encounter	Skull fractures with dural compromise where a membrane may be used to assist dural repair and prevent CSF leakage.
`C71.9`	Malignant neoplasm of brain, unspecified	Brain tumor resections often require dural reconstruction and use of membranes to aid healing.
`S06.5X9A`	Traumatic subdural hemorrhage without loss of consciousness, initial encounter	Evacuation of hematoma with dural repair may require membrane placement to reinforce closure.
`G06.0`	Intracranial abscess and granuloma	Surgical debridement and reconstruction may use membranes for dural or skull base repair.
`D16.1`	Benign neoplasm of skull and face bones	Resection and reconstruction of benign bone tumors often use membranes to support bone grafts and soft-tissue healing.
`M96.0`	Postlaminectomy syndrome of the lumbar region (Note: included for graft/membrane analogy in spinal dural repair)	Spinal dural repair procedures may use membranes; included when membrane use is for spinal dura rather than cranial.
`T90.2XXA`	Sequelae of intracranial injury, initial encounter	Reconstruction for sequelae such as CSF leak or dural defects may require membrane placement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61312`	Craniectomy or craniotomy for excision of lesion, intra-axial, supratentorial (e.g., tumor)	Primary neurosurgical procedure during which a dual-layer impax membrane may be placed for dural repair or reconstruction; `Q4262` billed as an add-on for membrane area.
`61520`	Craniectomy or craniotomy for intradural tumor, posterior fossa or foramen magnum	Posterior fossa approach where membrane placement may be required for dural closure; membrane billed per square centimeter with `Q4262`.
`13131`	Repair, complex, forehead, cheeks, eyelids, nose, lips, or ears; with extensive undermining, subcutaneous tissue rearrangement, or extensive closure (e.g., complex craniofacial soft tissue reconstruction)	Reconstructive soft-tissue procedures that may accompany membrane placement for layered closure and grafting.
`21248`	Reconstruction, mandible or maxilla, segmental, with bone graft; without microvascular anastomosis	Bony reconstruction procedures where membranes are used adjunctively for guided bone regeneration and listed as an add-on supply.
`69990`	Microsurgical techniques, requiring use of an operating microscope (List separately in addition to code for primary procedure)	Microsurgical or delicate reconstructive work performed concurrently with membrane placement; supports billing of add-on supplies like `Q4262`.

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