Coding, coverage, and reimbursement information provided does not constitute legal advice and does not guarantee payment. It is always the provider’s responsibility to determine and submit appropriate codes and charges for services rendered.

Reimbursement for surgical techniques is highly important to healthcare providers and patients. Selecting the most appropriate code(s) for each procedure can be influenced by many variables and should be evaluated based on the patient-specific circumstance for each case and the site of service.

To ensure your patient meets his/her carrier’s medical necessity policy criteria, or to find out if a pre-authorization or pre-determination is required, it is recommended that you contact the patient’s payer directly.

Also, visit the links below for other reimbursement resources regarding Prokera®, AmnioGraft®, and AmnioGuard® provided by our reimbursement consulting partners.

BioTissue Surgical has a Reimbursement Support Hotline which is available by contacting The Pinnacle Health Group. Their team of credentialed professional coders are able to provide support to physicians and facilities for their reimbursement needs such as:

• Coding guidance for our products
• Coverage criteria for specific payers
• Claim appeals and underpayment support
• Benefit verification and prior authorization requests
• Reimbursement and guidance documents
• Coding guide
• Letter of Medical Necessity
• Appeal Templates

Assigned HCPCS code for:

Q4148 | Applicable to Clarix 1K, Neox 1K, Neox RT, per square centimeter

Q4156 | Applicable to Clarix 100, Neox 100, per square centimeter