Summary & Overview
HCPCS Q4417: Alexiguard dl-t, per square centimeter (add-on)
HCPCS Level II code Q4417 designates Alexiguard dl-t billed per square centimeter as an add-on supply or product, to be reported in addition to a primary procedure. Nationally, this code matters because it standardizes reporting for area-based topical biologic or dermal therapies, enabling consistent billing and tracking of utilization for treatments applied by surface area. It is relevant to hospital outpatient departments, ambulatory surgical centers, wound care clinics, and other ambulatory settings where such products are used.
Key payers commonly involved in coverage and payment decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what the code represents clinically, typical sites of service, and which major payers are referenced in coverage conversations. The publication provides benchmarks and policy context where available, clarifies the code's role as an add-on line item billed per square centimeter, and outlines practical considerations for claims reporting and reimbursement workflows.
This summary serves payers, billing teams, revenue cycle managers, and clinicians who need a concise national-level reference for HCPCS Level II code Q4417 and its application in outpatient and ambulatory care settings.
Billing Code Overview
HCPCS Level II code Q4417 represents Alexiguard dl-t, billed per square centimeter as an add-on, listed separately in addition to the primary procedure. The code describes a topical or surface-applied biologic or therapeutic product measured and billed by area.
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Service type: Topical biologic/dermal treatment applied by surface area
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Typical site of service: Procedure settings where topical or surface wound/dermal therapies are applied, such as outpatient clinics, ambulatory surgical centers, wound care centers, and hospital outpatient departments
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Clinical & Coding Specifications
Clinical Context
A typical scenario involves a dermatologist or wound care specialist using the topical immunomodulatory agent applied to a localized dermatologic lesion or wound bed. A patient presents to an outpatient dermatology clinic with a biopsy-proven superficial skin malignancy (for example, superficial basal cell carcinoma) or a persistent precancerous lesion suitable for topical therapy. The clinician measures the lesion surface area in square centimeters and applies Q4417 as an add-on supply charge for the Alexiguard dl-t product used to cover the treated area. The clinical workflow includes lesion assessment, measurement (cm2), documentation of indication and consent, preparation of the site, application of the topical agent, and post-application instructions. The supplier documents product lot number, quantity used (cm2), and links the supply charge to the primary procedure or visit in the medical record and claim form.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when an E/M visit is provided in addition to the procedure involving Q4417 and documentation supports a distinct service |