Table of content for "Integra drt or omnigraft" (HCPCS Q4105)
General information on the “Q4105” code
HCPCS Code: Q4105
Long Description: Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter
Short Description: Integra drt or omnigraft
Original information is taken from Q4105 page
Pricing indicators
Pricing Indicator Code 1: 51 – Drugs
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 1 – Medical care
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20090101
Code Effective Date: 20170101
Action Code: N – No maintenance for this code