2025 HCPCS code A4100
Skin substitute, FDA cleared as a device, not otherwise specified.
Modifiers may be applicable depending on the specific circumstances of the procedure and the payer's requirements.
Medical necessity should be supported by documentation demonstrating the clinical need for the skin substitute, such as delayed wound healing, significant tissue loss, or infection risk.
The provider supplies and may apply the FDA-cleared skin substitute to a wound (e.g., ulcer, surgical wound, trauma wound) to assist healing. This code is used when no other specific code is applicable for the skin substitute used.
In simple words: This code is used for a skin substitute product approved by the FDA that helps wounds heal. It's used when there isn't a more specific code for the product.
This code reports a skin substitute that the Food and Drug Administration (FDA) has cleared as a device and for which no more specific code exists.It aids in wound management.
Example 1: A patient with a chronic diabetic ulcer receives a skin substitute application that does not have a more specific HCPCS code. A4100 is reported., A patient with a large surgical wound requires a skin substitute to aid in closure and healing.If the specific product used is not represented by another HCPCS code, A4100 is reported., A burn victim receives an FDA-cleared skin substitute graft in the emergency room. In the absence of a more specific code, A4100 is reported.
Documentation should include the type of wound, the specific product used (even though it falls under the "not otherwise specified" category), the location of the application, and the size of the wound treated.
** HCPCS Level II codes starting with 'A' cover ambulance and transport services, medical and surgical supplies, and administrative, miscellaneous, and investigational services.
- Specialties:Wound care, general surgery, plastic surgery, burn surgery, podiatry, dermatology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office, Skilled Nursing Facility, Home