Summary & Overview
HCPCS Q4267: Neostim per Square Centimeter, Add-On
Headline: HCPCS Level II code Q4267 designates Neostim applied per square centimeter as an add-on therapy
Lead: HCPCS Level II code Q4267 identifies the use of Neostim delivered per square centimeter as an add-on service to be billed in addition to a primary procedure. Nationwide, this code captures adjunctive topical or localized therapeutic applications tied to a primary procedural service and affects how payers reimburse for device- or drug-based procedural add-ons.
What it represents and why it matters: The code denotes area-based dosing and billing for Neostim, which has implications for procedure-level reimbursement, documentation, and coding workflows when the product is used alongside a primary intervention. Standardized reporting supports consistent claims submission and enables payers to distinguish base procedures from adjunctive treatments.
Key payers covered: Analysis includes major national payers such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides benchmarks and billing guidance context for Q4267, summarizes payer coverage considerations, highlights documentation elements tied to add-on reporting, and situates the code within clinical procedural workflows. Data not provided in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4267 represents Neostim dl, billed per square centimeter as an add-on service to be listed separately in addition to a primary procedure. The code is used to report application or use of Neostim delivered per unit area, indicating a product- or device-based adjunct applied during a procedure.
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Service type: Adjunctive device/drug application delivered per area (per square centimeter)
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Typical site of service: Procedure settings where an adjunctive topical or localized therapeutic agent is applied in conjunction with a primary procedure, such as outpatient procedure suites, ambulatory surgery centers, or hospital-based procedural areas.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with a chronic, non-healing neuropathic or ischemic wound undergoing advanced wound care receives topical application of a neostimulant dressing measured and billed by surface area. The clinical workflow begins with wound assessment by a wound care specialist (podiatrist, vascular surgeon, or wound care nurse practitioner) in an outpatient wound clinic or hospital-based wound center. Documentation includes wound size in square centimeters, wound etiology (for example, diabetic foot ulcer, venous stasis ulcer, or pressure injury), prior conservative therapies, and clinical rationale for adding a neostimulating agent to promote granulation and epithelialization. The procedure is performed at the bedside in an outpatient clinic, long-term care facility, or inpatient ward; the product is applied to the wound surface and secured per manufacturer instructions. The charge for the neostimulating product is reported with HCPCS Level II code Q4267 as an add-on supply billed in addition to the primary debridement or wound care procedure. Relevant clinical documentation includes wound measurements, product quantity (square centimeters), application technique, device lot number, patient tolerance, and follow-up plan for dressing changes and reassessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/standard service | Use when no other specific modifier is appropriate; indicates usual service. |