HCPCS Code Section: HCPCS Q Codes

Arthroflex, per square centimeter Short Description: Arthroflex Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2012 Effective Date: January 1, 2012 Termination …

Oasis ultra tri-layer wound matrix, per square centimeter Short Description: Oasis tri-layer wound matrix Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Alloskin rt, per square centimeter Short Description: Alloskin Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2012 Effective Date: January 1, 2012 …

Dermacell, dermacell awm or dermacell awm porous, per square centimeter Short Description: Dermacell, awm, porous sq cm Coverage Code: Carrier judgment Action Code: Change in long description of procedure …

Theraskin, per square centimeter Short Description: Theraskin Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2011 Effective Date: January 1, 2018 Termination …

Matristem burn matrix, per square centimeter Short Description: Matristem burn matrix Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2011 Effective Date: …

Matristem wound matrix, per square centimeter Short Description: Matristem wound matrix Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2011 Effective Date: …

Matristem micromatrix, 1 mg Short Description: Matristem micromatrix Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2011 Effective Date: January 1, 2014 …

Hyalomatrix, per square centimeter Short Description: Hyalomatrix Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2011 Effective Date: January 1, 2011 Termination …

Alloderm, per square centimeter Short Description: Alloderm Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: July 1, 2009 Effective Date: January 1, 2014 Termination …