Summary & Overview

HCPCS Level II Q4387: Neothelium per Square Centimeter (Add-on)

HCPCS Level II code Q4387 denotes billing for neothelium per square centimeter as an add-on service, intended to be reported in addition to a primary surgical or wound-care procedure. Nationally, add-on supply and graft material codes like Q4387 matter because they affect how facilities and clinicians report incremental materials and services that alter procedure cost and clinical resource use.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context, typical sites of service, and how it integrates with primary procedures. The publication provides benchmarking context where available, notes common modifiers and billing practices, and highlights payer coverage patterns and policy considerations that affect reimbursement and billing compliance.

This summary equips billing professionals, clinicians, and policy analysts with the essentials needed to identify when Q4387 applies, what to include on the claim, and where to look for payer-specific rules and coverage policies.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareQ4387HCPCS Level IIneotheliumadd-on codesurgical adjunctgrafting materialprocedure suppliesoutpatient surgeryhospital billing

Billing Code Overview

HCPCS Level II code Q4387 describes Neothelium ft, per square centimeter as an add-on, list separately in addition to primary procedure. This code represents billing for neothelial graft material or treatment measured and billed per square centimeter when used alongside a primary surgical or wound care procedure.

Service type: Surgical adjunct / grafting material application
Typical site of service: Operating room, outpatient surgical center, or hospital procedural setting

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a patient undergoing surgical resection of a lesion where a neothelium (artificial or biologic neothelial graft material) is applied and billed per square centimeter as an add-on service. For example, a 62-year-old patient with a chronic non-healing cutaneous defect after tumor excision requires application of a neothelial dressing to promote epithelialization. The workflow includes preoperative assessment, excision of the lesion under local or general anesthesia in an ambulatory surgical center or hospital outpatient department, measurement of the area treated, and application of the neothelium product. The surgeon documents the square centimeters of neothelium applied, links the add-on Q4387 to the primary surgical procedure in the operative report, and appends appropriate modifiers to reflect circumstances such as professional component, significant additional work, or bilateral procedures. Typical sites of service are ambulatory surgical centers, hospital outpatient departments, and inpatient operating rooms when combined with the primary procedure. The service is performed by surgical specialists such as plastic surgery, general surgery, or dermatologic surgery teams, and may involve postoperative dressing changes and follow-up wound assessments billed under separate evaluation and management or procedural codes as appropriate.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

Taxonomy Code	Specialty	Notes
208000000X	General Surgery	Surgeons performing excisions and reconstructive wound management who may apply neothelium.
208C00000X	Plastic Surgery	Common specialty for complex wound coverage and grafting procedures using neothelium.
207N00000X	Dermatology	Dermatologic surgeons treating cutaneous defects and applying biologic dressings.
208600000X	Otolaryngology	Head and neck surgeons who may use neothelium for mucosal or external surface reconstruction.
207P00000X	Podiatry	Podiatric surgeons treating foot and ankle wounds where neothelium may be applied.

ICD-10 Code	Description	Clinical Relevance
`L98.4`	Chronic ulcer of skin, not elsewhere classified	Chronic non-healing ulcers often require biologic dressings or neothelial coverage to promote healing.
`L89.309`	Pressure ulcer of sacral region, unspecified stage	Pressure injuries with tissue loss may receive neothelium as part of wound management.
`S81.811A`	Laceration without foreign body of right lower leg, initial encounter	Acute traumatic wounds after debridement and closure may receive neothelium to support epithelialization.
`C44.91`	Basal cell carcinoma of skin of unspecified site of face	After oncologic excision, neothelium can be applied to surgical defects to aid healing.
`K64.9`	Hemorrhoids, unspecified	Perianal surgical defects or excisions occasionally use biologic dressings; neothelium may be applied in select cases.
`E10.621`	Type 1 diabetes mellitus with foot ulcer	Diabetic foot ulcers are common indications for advanced wound care including neothelium application.
`M86.60`	Osteomyelitis, unspecified site, unspecified	Following surgical debridement for osteomyelitis, neothelium may be used as part of soft tissue coverage strategies.
`T81.31XA`	Disruption of external operation (surgical) wound, initial encounter	Wound dehiscence situations may be managed with adjunctive neothelium to promote re-epithelialization.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12002`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.6 cm to 7.5 cm	May be the primary procedure for which neothelium `Q4387` is applied as an adjunct to enhance healing for a repaired wound.
`15271`	Application of skin substitute graft to trunk, arms, legs; first 100 sq cm or less, or 1 percent of body surface area of infants and children	A commonly paired CPT for biologic skin substitute placement; `Q4387` may be billed in addition when neothelium product is measured per square centimeter.
`15777`	Other sheet graft, free, includes preparation of recipient site; trunk, arms, legs, or greater than 100 sq cm	Performed when larger grafting is required; neothelium product billing `Q4387` may be used as an add-on for supplemental coverage.
`49320`	Repair, inguinal hernia, age 5 years or older; reducible	Example of an unrelated primary procedure where neothelium would not typically apply; included only when wound coverage adjunct is used — Data not available in the input.
`13131`	Secondary closure of surgical wound or debridement, extensive undermining, trunk, arms, legs; 10.1 cm to 30.0 cm	May precede or accompany application of neothelium as adjunctive coverage after extensive closure or debridement.

Note: If any CPT relationships are not clinically relevant for a particular case, provider documentation must support the clinical necessity and linkage between the primary CPT and the add-on Q4387.

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