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Graftjacket, per square centimeter

HCPCS code

Medical Policies and Guidelines for Graftjacket, per square centimeter

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Similar Codes


ICD10CM codes

T85.623 - Displacement of artificial skin graft and decellularized allodermis
T85.613 - Breakdown (mechanical) of artificial skin graft and decellularized allodermis
T85.613A - Breakdown (mechanical) of artificial skin graft and decellularized allodermis, initial encounter
T85.623A - Displacement of artificial skin graft and decellularized allodermis, initial encounter
T86.820 - Skin graft (allograft) rejection
T82.339 - Leakage of unspecified vascular graft
T85.693 - Other mechanical complication of artificial skin graft and decellularized allodermis
T85.623S - Displacement of artificial skin graft and decellularized allodermis, sequela
T82.828 - Fibrosis due to vascular prosthetic devices, implants and grafts
T85.613D - Breakdown (mechanical) of artificial skin graft and decellularized allodermis, subsequent encounter

HCPCS codes

Q4107 - Graftjacket, per square centimeter
Q4106 - Dermagraft, per square centimeter
Q4101 - Apligraf, per square centimeter
Q4116 - Alloderm, per square centimeter
Q4117 - Hyalomatrix, per square centimeter
Q4121 - Theraskin, per square centimeter
Q4204 - Xwrap, per square centimeter
Q4154 - Biovance, per square centimeter
Q4160 - Nushield, per square centimeter
Q4108 - Integra matrix, per square centimeter

CPT4 codes

15040 - Harvest of skin for tissue cultured skin autograft, 100 sq cm or less
15271 - Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm;
15200 - Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less
15201 - Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm,
20910 - Cartilage graft; costochondral
15272 - Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm;
15273 - Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or
15274 - Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or
15220 - Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq
15240 - Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, n