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Xwrap, per square centimeter

HCPCS code

Medical Policies and Guidelines for Xwrap, per square centimeter

Related policies from health plans

Bioengineered Skin and Soft Tissue Substitutes (CG030)
Tissue Engineered Skin Substitutes - (0068)
Skin and Tissue Substitutes - Medicare Advantage

Similar Codes


ICD10CM codes

C44.520 - Squamous cell carcinoma of anal skin
Z48.1 - Encounter for planned postprocedural wound closure
Z48.00 - Encounter for change or removal of nonsurgical wound dressing
Z48.01 - Encounter for change or removal of surgical wound dressing
Z48.817 - Encounter for surgical aftercare following surgery on the skin and subcutaneous tissue
C44.92 - Squamous cell carcinoma of skin, unspecified
C44.521 - Squamous cell carcinoma of skin of breast
C44.82 - Squamous cell carcinoma of overlapping sites of skin
C44.529 - Squamous cell carcinoma of skin of other part of trunk
C44.52 - Squamous cell carcinoma of skin of trunk

HCPCS codes

Q4204 - Xwrap, per square centimeter
Q4186 - Epifix, per square centimeter
Q4195 - Puraply, per square centimeter
Q4121 - Theraskin, per square centimeter
Q4196 - Puraply am, per square centimeter
Q4110 - Primatrix, per square centimeter
Q4136 - Ez-derm, per square centimeter
Q4163 - Woundex, bioskin, per square centimeter
Q4116 - Alloderm, per square centimeter
Q4160 - Nushield, per square centimeter

CPT4 codes

41828 - Excision of hyperplastic alveolar mucosa, each quadrant (specify)
11045 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 s
41820 - Gingivectomy, excision gingiva, each quadrant
11042 - Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or le
15272 - Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm;
14302 - Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (Li
15271 - Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm;
14301 - Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm
12045 - Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm
12047 - Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm