Q4288 Dermabind (HCPCS) Reimbursement & Policy | OpenPayer

Summary & Overview

HCPCS Q4288: Dermabind Dermal Adhesive, Per Square Centimeter

HCPCS Level II code Q4288 designates Dermabind charged per square centimeter as an add-on code to be reported in addition to a primary procedure for wound closure. This code matters nationally because it standardizes billing for per-square-centimeter application of a dermal adhesive product, which affects procedure-level payment reporting and product utilization tracking across outpatient and ambulatory surgical settings. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical context for use of Q4288 as an adjunctive wound closure measure, typical sites of service where it is billed, and the role of add-on HCPCS Level II codes in documenting product-based charges. The publication provides benchmarks and payer coverage context where available, outlines common billing practices tied to per-square-centimeter reporting, and flags policy considerations relevant to payers and billing administrators. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareQ4288HCPCS Level IIDermal adhesiveWound closureAdd-on codeOutpatient surgeryAmbulatory careProcedure billing

Billing Code Overview

HCPCS Level II code Q4288 describes Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure). This code is used to report the application of a dermal adhesive or wound closure product billed per square centimeter as an add-on service alongside a primary procedure.

Service type: Wound closure adjunct (dermal adhesive application)
Typical site of service: Ambulatory surgical centers, hospital outpatient departments, physician offices, and other procedural settings where primary surgical or wound management procedures are performed.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a patient with a traumatic or surgical soft-tissue wound requiring topical adhesive reinforcement. Dermabind is billed as an add-on, per square centimeter, coded as Q4288 to report the application of cyanoacrylate tissue adhesive over a primary procedure that provides definitive wound closure (for example, suturing or staple removal). The workflow begins with wound assessment, primary closure (e.g., layered closure or simple interrupted sutures), hemostasis, and irrigating the wound. After primary closure is complete, the provider measures the area to be covered with adhesive and documents the square centimeters treated. The adhesive is applied in a thin layer over the closed incision or laceration to provide surface reinforcement, microbial barrier, and potentially improved cosmesis. Documentation should include the primary procedure code, the number of square centimeters of Dermabind applied, indication for adhesive use (e.g., tension reduction, small linear laceration overlay, or fragile skin), and any modifier(s) to explain unusual circumstances (for example, increased procedural complexity). Typical sites of service include hospital outpatient departments, ambulatory surgical centers, urgent care clinics, and office-based procedure settings where a primary wound-closure procedure is performed and the adhesive is applied as an adjunctive treatment. Common patient scenarios include repair of traumatic lacerations after motor vehicle collisions, elective excision with layered closure requiring topical reinforcement, or closure of fragile skin in elderly patients to reduce the risk of dehiscence.

Coding Specifications

Modifier	Description	When to Use

HCPCS Q5157: Denosumab (biosimilar) Injection, 1 mg

HCPCS-Q9960-HIGH-OSMOLAR-CONTRAST-200-249-MG-ML-IODINE

HCPCS Q9960: High Osmolar Contrast, 200–249 mg/ml, per ml

HCPCS-Q4074-ILOPROST-INHALATION-SOLUTION-UNIT-DOSE-DME

HCPCS Q4074: Iloprost Inhalation Solution, Unit Dose via DME

HCPCS-Q0489-POWER-PACK-BASE-VENTRICULAR-ASSIST-DEVICE-REPLACEMENT

HCPCS Q0489: Power Pack Base for Ventricular Assist Device, Replacement

HCPCS-Q4285-NUDYN-DL-MESH-PER-SQ-CM-ADD-ON

HCPCS Q4285: Nudyn dl Mesh, Per Square Centimeter (Add-on)

HCPCS-Q9954-ORAL-MRI-CONTRAST-AGENT-PER-100ML

HCPCS Q9954: Oral Magnetic Resonance Contrast Agent, per 100 ml

HCPCS-Q4157-REVITALON-PER-SQ-CM-ADD-ON

HCPCS Q4157: Revitalon, per Square Centimeter (Add-on)

HCPCS-Q4426-DERMABIND-TOPICAL-WOUND-CLOSURE-PER-SQ-CM

HCPCS Level II Q4426: Dermabind topical wound closure, per sq cm

HCPCS-Q4299-AMNIOCORE-PRO-PER-SQ-CM-AMNIOTIC-MEMBRANE-GRAFT

HCPCS Level II Q4299: Amniocore Pro+, Per Square Centimeter

HCPCS-Q4286-NUDYN-SL-SURFACE-PRODUCT-PER-SQ-CM

HCPCS Q4286: Nudyn SL/Nudyn SLW, Topical Product per sq cm

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`00`	No modifier — standard reporting	Use when no special circumstances apply and the add-on code is reported as usual.
`22`	Increased procedural services	Use when work required to apply the adhesive is substantially greater than typical and documentation supports increased complexity.
`23`	Unusual anesthesia	Use when general anesthesia is unexpectedly required for the primary procedure and the add-on adhesive is part of that operative encounter.
`52`	Reduced services	Use when the adhesive application was partially performed or the service was reduced compared with the full described service.
`53`	Discontinued procedure	Use when the primary procedure was started but discontinued and the adhesive was nevertheless applied or attempted; document reason.
`54`	Surgical care only	Use when reporting only the surgical portion (e.g., inpatient surgeon) and the adhesive application is part of the surgical encounter.
`55`	Postoperative management only	Use when only postoperative care is provided and the adhesive application was part of post-op wound management.
`56`	Preoperative management only	Use when only preoperative management is reported separate from the operative procedure that included adhesive application.
`62`	Two surgeons	Use when two surgeons with different specialties are required and both participated in the operative repair that included adhesive application.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service	Use to identify services performed by designated nonphysician clinicians when payer requires this modifier.
`CO`	Collision liability or litigation	Use when billing is related to auto accident or third-party liability circumstances and payer requires the modifier.
`CQ`	Service furnished by a resident, without attending physician present	Use when a resident provides the procedure without direct attending physician presence and payer recognizes `CQ`.
`FX`	Special payment adjustment — modifiers used for certain controlled substances or products	Use only if payer-specific policy requires this modifier for product-based adjustments associated with the adhesive.
`QX`	Qualified nonphysician practitioner with modifier `QY` relationship	Use when the service is furnished by a qualified nonphysician practitioner and billing requires identification of a supervising physician relationship via `QY` and `QX` pair.

Taxonomy Code	Specialty	Notes
207T00000X	Plastic Surgery	Common specialty performing layered closures and topical adhesive reinforcement for cosmetic outcomes.
207L00000X	Dermatology	Frequently performs skin lesion excision and wound closure with adhesive adjuncts.
207P00000X	General Surgery	Repairs traumatic lacerations and surgical wounds where add-on adhesive may be applied.
363L00000X	Emergency Medicine	Applies adhesives adjunctively after primary wound closure in urgent care or ED settings.
208000000X	Family Medicine	Office-based wound closure and topical adhesive application for minor procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S01.81XA`	Laceration without foreign body of face, initial encounter	Facial lacerations commonly closed with sutures and reinforced with topical adhesive to protect the closure.
`S31.311A`	Laceration without foreign body of abdominal wall, initial encounter	Truncal lacerations repaired with primary closure may receive adhesive overlay billed with `Q4288`.
`S41.011A`	Laceration without foreign body of right shoulder, initial encounter	Extremity lacerations where adhesive provides wound-edge support and microbial barrier after suturing.
`L98.9`	Disorder of skin and subcutaneous tissue, unspecified	Broad dermatologic indications where adhesive may be used after minor surgical procedures.
`T81.31XA`	Disruption of external operation (wound) (due to inadequate closure), initial encounter	Adhesive may be used as adjunctive reinforcement in wound management following complications of closure.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12001`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.5 cm or less	Primary closure code for small superficial lacerations where `Q4288` may be applied as an adjunctive topical adhesive over the repaired area.
`12032`	Repair, intermediate wounds of scalp, axillae, trunk and/or extremities; 2.5 cm or less	Used for intermediate layered closure of lacerations; `Q4288` can be reported in addition for adhesive coverage per cm2.
`13160`	Repair of complex trunk/limb wounds (e.g., involving tissue loss), secondary closure	Applied when complex closures are performed; adhesive `Q4288` may be used for surface reinforcement after definitive closure.
`11100`	Biopsy of skin, subcutaneous tissue and/or mucous membrane (including closure, when performed)	Excisional procedures with closure where adhesive adjunct may be used post-closure and billed with `Q4288` for area treated.
`12020`	Revision of recent simple repair (within 90 days)	When repair requires revision and adhesive is applied over the revised closure; `Q4288` reported per square centimeter as an add-on.

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