HCPCS Code Section: HCPCS Q Codes

Restorigin, 1 cc Short Description: Restorigin, 1 cc Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January 1, 2019 …

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

Restorigin, per square centimeter Short Description: Restorigin 1 sq cm Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January …

Miroderm, per square centimeter Short Description: Miroderm Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2017 Effective Date: January 1, 2017 Termination …

Artacent ac, per square centimeter Short Description: Artacent ac 1 sq cm Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective …

Palingen or promatrx, 0.36 mg per 0.25 cc Short Description: Palingen or promatrx Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2017 …

Fluid flow or fluid gf, 1 cc Short Description: Fluid flow or fluid gf 1 cc Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: …

Membrane graft or membrane wrap, per square centimeter Short Description: Membrane graft or wrap sq cm Coverage Code: Carrier judgment Action Code: Add procedure or modifier code Date Added: …

Xwrap, per square centimeter Short Description: Xwrap 1 sq cm Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January …

Derma-gide, per square centimeter Short Description: Derma-gide, 1 sq cm Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 2019 Effective Date: January …