Summary & Overview
HCPCS Q4292: Lamellas per Square Centimeter (Add-on Supply)
HCPCS Level II code Q4292 denotes lamellas billed per square centimeter as an add-on item reported in addition to a primary procedure. This supply-oriented HCPCS add-on code is used when lamellar material is measured and billed by surface area and is relevant to surgical specialties that use grafts, meshes, or lamellar constructs. Nationally, precise reporting of add-on supply units affects procedural accounting, supply-cost transparency, and claims adjudication for facility-based and outpatient surgeries.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical and billing context, which service lines typically use the code, and common operational considerations for coding and claims submission. The publication provides benchmarks where available, notes on payer coverage patterns, and summaries of typical sites of service. It also identifies gaps where data was not provided, such as specific associated taxonomies or ICD-10 diagnoses.
This summary is written for a national audience and is designed to inform billing teams, revenue cycle managers, and clinical staff about the purpose and application of HCPCS Level II code Q4292, without making clinical or payer-specific recommendations.
Billing Code Overview
HCPCS Level II code Q4292 describes lamellas billed per square centimeter as an add-on supply or device reported separately in addition to a primary procedure. This code represents a unit-based billing item where the measure is the surface area of lamellar material used.
Service Type: Durable medical supply or surgical adjunct (lamellar material)
Typical Site of Service: Operating room, outpatient surgical center, or facility-based procedure setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric recipient of a corneal or ocular surface reconstruction procedure requiring lamellar graft material measured and billed per square centimeter. The procedure is an add-on supply designation used when the surgeon or surgical team places engineered lamellar tissue (lamellas) during a primary corneal procedure such as anterior lamellar keratoplasty, endothelial keratoplasty, or complex ocular surface reconstruction. Workflow: preoperative evaluation documents the indication (e.g., corneal stromal thinning, keratoconus, corneal scarring, or failed prior graft) and planned lamellar graft. Intraoperatively the team trims and places lamellar tissue; the supply charge for lamellas is measured in square centimeters and appended to the primary procedure. Postoperative follow-up documents graft positioning, adherence, and any complications such as rejection or detachment. Billing: Q4292 is reported as an add-on supply code in addition to the primary corneal surgical CPT code, with appropriate modifiers to indicate circumstances (e.g., bilateral, increased procedural services, or transfer of patient care).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons work together as primary surgeons performing distinct portions of the corneal reconstruction requiring lamellas |