Summary & Overview
HCPCS Q4346: Shelter Dermal Matrix, Per Square Centimeter
HCPCS Level II code Q4346 identifies a shelter dermal matrix material billed per square centimeter as an add-on supply reported alongside a primary procedure. This code captures use of an implanted or applied dermal matrix product during surgical reconstruction or wound management and is relevant for hospitals, ambulatory surgical centers, and providers performing reconstructive procedures. Nationally, accurate coding of add-on supply products like Q4346 matters for clinical documentation, billing transparency, and consistent payment handling across public and private payers.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, typical clinical contexts and sites of service, and which payers are commonly involved. The publication outlines expected uses of the code, common modifiers reported with procedural add-ons (listed elsewhere in the full document), and the implications for claim submission workflows. Where input data is missing, the document notes that specific taxonomy mappings, associated ICD-10 diagnoses, detailed payer policy variations, and related codes are not available in the input. This summary is written for a national audience to support coding accuracy and billing consistency when Q4346 is used in surgical and wound care settings.
Billing Code Overview
HCPCS Level II code Q4346 describes a shelter dm matrix, billed per square centimeter; it is an add-on supply/implant code intended to be reported in addition to a primary procedure. The service type is a specialized surgical or wound care supply involving placement or use of a shelter dermal matrix. The typical site of service is operative or procedural settings such as inpatient or outpatient surgical departments, ambulatory surgical centers, or other sterile procedural locations where wound reconstruction or grafting occurs.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with a chronic, non-healing wound (for example, a pressure ulcer, diabetic foot ulcer, or complex surgical wound) presents to an outpatient wound care clinic or a hospital-based wound center. After wound bed preparation, debridement, and assessment by the wound care specialist, a clinician applies a skin substitute or shelter dermal matrix product to the wound surface to promote granulation and closure. The product represented by Q4346 is billed per square centimeter as an add-on to the primary application procedure. Typical workflow: wound assessment and measurement, cleansing and debridement, selection and sizing of the dermal matrix, application and fixation of the matrix to the wound bed, documentation of product quantity in square centimeters, and coordination of follow-up visits for dressing changes and reassessment. Typical sites of service include outpatient wound care clinics, ambulatory surgery centers, and inpatient hospital units when used as part of complex wound management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Unusual procedural service (increased procedural services) | Use when services are substantially greater than typically required for the procedure accompanying the add-on product due to complexity. |