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Q4133
Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter
HCPCS code
Medical Policies and Guidelines for Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter
Related policies from health plans
OSCAR
Bioengineered Skin and Soft Tissue Substitutes (CG030)
CIGNA
Tissue Engineered Skin Substitutes - (0068)
CIGNA
Tissue Engineered Skin Substitutes - (0068)
CIGNA
Tissue Engineered Skin Substitutes - (0068)
CIGNA
Tissue Engineered Skin Substitutes - (0068)
ANTHEM-BLUECROSS-CT
SURG.00011 Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting
Similar Codes
ICD10CM codes
T82.868A
- Thrombosis due to vascular prosthetic devices, implants and grafts, initial encounter
T82.867A
- Thrombosis due to cardiac prosthetic devices, implants and grafts, initial encounter
O43.231
- Placenta percreta, first trimester
Z29.3
- Encounter for prophylactic fluoride administration
Z95.5
- Presence of coronary angioplasty implant and graft
T82.868
- Thrombosis due to vascular prosthetic devices, implants and grafts
T84.86XA
- Thrombosis due to internal orthopedic prosthetic devices, implants and grafts, initial encounter
Z95.820
- Peripheral vascular angioplasty status with implants and grafts
T83.86XA
- Thrombosis due to genitourinary prosthetic devices, implants and grafts, initial encounter
L43
- Lichen planus
HCPCS codes
Q4133
- Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter
Q4132
- Grafix core and grafixpl core, per square centimeter
Q4110
- Primatrix, per square centimeter
Q4186
- Epifix, per square centimeter
Q4131
- Epifix or epicord, per square centimeter
Q4204
- Xwrap, per square centimeter
Q4136
- Ez-derm, per square centimeter
Q4195
- Puraply, per square centimeter
Q4128
- Flex hd, allopatch hd, or matrix hd, per square centimeter
Q4196
- Puraply am, per square centimeter
CPT4 codes
41820
- Gingivectomy, excision gingiva, each quadrant
85260
- Clotting; factor X (Stuart-Prower)
85290
- Clotting; factor XIII (fibrin stabilizing)
41828
- Excision of hyperplastic alveolar mucosa, each quadrant (specify)
99188
- Application of topical fluoride varnish by a physician or other qualified health care professional
80181
- Flecainide
31830
- Revision of tracheostomy scar
72126
- Computed tomography, cervical spine; with contrast material
74263
- Computed tomographic (CT) colonography, screening, including image postprocessing
35301
- Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck