2025 HCPCS code Q4103

Oasis burn matrix, per square centimeter.

Refer to current HCPCS coding guidelines for proper usage and reporting of Q4103. Report Q4103 once for each square centimeter of the matrix used.

Modifiers may be applicable depending on the specific circumstances of the procedure. Consult modifier guidelines for accurate reporting.

Medical necessity for Q4103 is determined by the need for a skin substitute to promote healing in superficial and second-degree burns. The documentation must support the medical necessity of using this specific product.

Physicians or other qualified healthcare providers apply the Oasis burn matrix.Proper documentation of the burn's size and location is crucial for accurate coding and reimbursement.

In simple words: This code covers the cost of a special wound dressing, called Oasis burn matrix, used to help heal minor and moderate burns. The cost is calculated based on the size of the burn area covered.

This code represents Oasis burn matrix, which is used to treat superficial and second-degree burns.It's reported per square centimeter of the matrix applied.

Example 1: A patient presents with a 20 sq cm second-degree burn on their arm.The physician applies Oasis burn matrix to the affected area.The code Q4103 is reported 20 times to represent the 20 square centimeters of matrix used., A child with a superficial burn covering 50 sq cm on their leg receives treatment with Oasis burn matrix.The provider reports Q4103 x 50., A patient undergoes a skin graft procedure, and Oasis burn matrix is used at the donor site, which measures 35 sq cm.Q4103 is reported 35 times, along with the appropriate CPT code for the skin graft procedure itself.

Documentation should include the size of the burn (in square centimeters), the location of the burn, and the type of burn (superficial or second-degree). Documentation of the application procedure and medical necessity is essential.

** Q codes are temporary codes for supplies, drugs, and biologicals that don't have a permanent HCPCS code.Always ensure proper documentation to support the medical necessity of the procedure.Check with individual payers for coverage policies regarding skin substitutes.

  • Payment Status: Active
  • Specialties:Burn specialists, dermatologists, general surgeons, plastic surgeons, and wound care specialists are some of the specialties that may utilize this code.
  • Place of Service:Physician's office, hospital outpatient department, ambulatory surgical center, burn center, and other settings where burn care is provided.
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