Summary & Overview
HCPCS Q4379: Amniodefend Amniotic Matrix, per sq cm
HCPCS Level II code Q4379 designates Amniodefend fetal tissue matrix billed per square centimeter as an add-on product. The code applies when this biologic amniotic membrane matrix is used in addition to a primary procedure to support wound healing or tissue repair. Nationally, use of amniotic and other biologic matrices has increased across surgical and wound-care settings because of their potential to improve healing outcomes and to serve as adjunctive graft materials.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for the product, the common service settings where Q4379 is reported, and the implications for billing when the matrix is billed as an add-on per square centimeter. The publication outlines available benchmarks and coverage considerations where present and flags areas where data are not available in the input. It also summarizes typical documentation and billing practices tied to add-on biologic products.
This overview is intended for coding professionals, revenue cycle staff, and clinicians who need a national-level reference for the code's clinical use and payer coverage landscape.
Billing Code Overview
HCPCS Level II code Q4379 represents Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure). This code describes a biologic amniotic membrane matrix product used as an adjunctive graft or wound coverage measured and billed per square centimeter.
Service Type: Biologic graft / wound covering adjunct
Typical Site of Service: Outpatient surgical settings and wound care clinics where adjunctive graft materials are applied in conjunction with a primary procedure, including ambulatory surgery centers and hospital outpatient departments.
Clinical & Coding Specifications
Clinical Context
A patient with a chronic, non-healing soft tissue defect of the oral mucosa or periodontal tissues presents to an outpatient oral surgery or periodontics clinic. The patient has persistent exposure of underlying structures after prior debridement and local therapy and is a candidate for adjunctive biologic wound matrix placement. During a scheduled procedure under local anesthesia (with or without sedation) or in an ambulatory surgery center, the surgeon prepares the wound bed, custom-cuts the amniotic membrane-derived matrix (billed as Q4379 per square centimeter as an add-on) to size, and secures it to the defect with sutures or tissue adhesive. Typical workflow steps include preoperative evaluation and consent; intraoperative wound bed preparation, placement of the matrix, and hemostasis; and postoperative instructions and follow-up visits for dressing changes and assessment of graft integration. Common settings include dental/periodontal offices, outpatient surgery centers, and hospital outpatient departments. The procedure is billed as an add-on supply (Q4379) in addition to the primary surgical procedure code for the debridement, excision, or periodontal surgery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard billing | Use when no special circumstances apply and the service is billed routinely. |