Summary & Overview
HCPCS Level II Q4307: American Amnion Allograft, Per Square Centimeter
Headline: HCPCS Level II code Q4307 covers American amnion allografts used as an add-on graft material
Lead: HCPCS Level II code Q4307 identifies the supply of American amnion measured per square centimeter and billed as an add-on item in addition to a primary surgical procedure. This code is relevant nationally for facilities and clinicians that utilize amniotic membrane allografts for tissue reconstruction, wound coverage, or surgical adjuncts.
What this code represents and why it matters: The code denotes a biologic graft product — American amnion — supplied and billed per unit area. As an add-on code, Q4307 is billed in conjunction with primary procedures and affects procedure-level supply costs, documentation practices, and payer adjudication for biologic materials.
Key payers covered: Analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides benchmarks for how this add-on biologic is billed and reimbursed, summarizes clinical contexts where amnion grafts are used, and outlines coding and billing considerations tied to add-on supply reporting. It highlights payer coverage patterns and policy updates where available, as well as typical sites of service and operational implications for surgical teams and billing departments.
Data limitations: Data not available in the input for associated taxonomies, specific ICD-10 pairings, and payer-specific reimbursement rates.
Billing Code Overview
HCPCS Level II code Q4307 describes American amnion, per square centimeter (add-on, list separately in addition to primary procedure). This code represents a biologic allograft derived from human amniotic membrane intended for use as a graft or wound covering during surgical procedures.
Service Type: Biologic allograft application
Typical Site of Service: Operating room or procedure suite
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a chronic, nonhealing soft tissue defect or surgical wound (for example, diabetic foot ulcer, venous stasis ulcer, or a post-debridement surgical wound) requiring biologic grafting to promote healing. The patient presents to an outpatient wound care clinic or hospital-based outpatient department after conservative measures (dressings, offloading, local wound care) have failed. A wound care specialist or surgeon evaluates the wound, documents size in square centimeters, performs necessary debridement and irrigation, obtains informed consent, and prepares the wound bed. During the same encounter, the clinician applies an amniotic membrane allograft product (commercially supplied human amnion) trimmed to the measured surface area. The procedure is billed as an add-on product per square centimeter using Q4307 in addition to a primary procedure code such as a debridement or wound closure CPT. Typical sites of service include outpatient wound care centers, hospital outpatient departments, ambulatory surgery centers, and occasionally inpatient operating rooms when applied during surgical reconstruction. Common clinical workflow steps: pre-procedure assessment and documentation of wound characteristics and prior treatments; wound bed preparation (sharp or enzymatic debridement as needed); measurement and documentation of graft area (cm2); application and fixation of the amniotic membrane; dressing and post-procedure instructions; and follow-up wound assessments and coding of any subsequent procedures or complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|