Summary & Overview
HCPCS Q4343: Dermacyte AC Matrix Amniotic Membrane Allograft, per cm2
HCPCS Level II code Q4343 represents the per-square-centimeter billing unit for Dermacyte AC matrix, an amniotic membrane allograft used as an adjunctive graft material in tissue repair and wound management. As an add-on supply code, Q4343 is billed in addition to the primary procedure when clinicians apply the amniotic membrane product. The code matters nationally because biologic graft materials are increasingly used in complex wounds and reconstructive procedures, driving attention to supply-level coding, unitization, and appropriate add-on reporting.
Key payers evaluated include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical role and common sites of service, plus what to expect in payer coverage discussions: unit-based billing per square centimeter, typical outpatient and clinic settings, and the implication that this code supplements a primary surgical or wound procedure. The publication outlines benchmarks and policy considerations relevant to add-on biologic grafts, summarizes reimbursement and coding practice trends where available, and situates Q4343 within broader clinical contexts such as wound care and reconstructive procedures.
Data not available in the input for specific payer policy language, associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
HCPCS Level II code Q4343 describes Dermacyte ac matrix amniotic membrane allograft, per square centimeter. This is an add-on, list separately in addition to primary procedure supply used in tissue repair and wound management.
Service Type: Amniotic membrane allograft application / biologic graft material
Typical Site of Service: Outpatient surgical settings, wound care centers, and clinic-based procedural rooms
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a non-healing lower extremity wound (e.g., diabetic foot ulcer or venous stasis ulcer) present after conservative care for several weeks. The wound care team — commonly a podiatrist, vascular surgeon, or wound care specialist — evaluates the wound in an outpatient clinic or ambulatory surgery center. After wound bed preparation (debridement, infection control, hemostasis and appropriate offloading or compression), the clinician measures the wound area in square centimeters and applies Q4343 Dermacyte AC Matrix amniotic membrane allograft as an adjunctive biologic dressing to promote healing. The product is billed as an add-on per square centimeter in addition to the primary wound care procedure. Typical site of service is outpatient wound care clinic, physician office, or ambulatory surgery center. Common clinical workflow steps: wound assessment and measurement, sharp or surgical debridement (if required), appropriate antimicrobial management, application of the amniotic membrane allograft sized to the wound area, dressing and post-procedure instructions, and scheduled follow-up for graft assessment and repeat applications if clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/placeholder (no specific modifier) | Use when no other modifier applies and standard billing is intended |