Skin substitute HCPCS codes no longer requiring a paper invoice (JN)
To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
When the invoice information is entered in the narrative field on a claim for any of the HCPCS codes listed below, it is not necessary to provide the actual paper invoice for these services. For details, view our article on the process for supplying invoice amount on certain HCPCS codes to avoid rejected claims.
| Code | Description | Effective "from" date of service | Effective "through" date of service |
|---|---|---|---|
| A2006 | NovoSorb SynPath dermal matrix, per sq cm | 1/1/2024 | Present |
| A2009 | Symphony, per sq cm | 1/1/2024 | 12/31/2024 |
| A2010 | Apis, per sq cm | 1/1/2024 | Present |
| A2011 | Supra SDRM, per sq cm | 1/1/2024 | Present |
| A2012 | SUPRATHEL, per sq cm | 1/1/2024 | Present |
| A2016 | PermeaDerm B, per sq cm | 1/1/2024 | Present |
| A2017 | PermeaDerm Glove, each | 1/1/2024 | Present |
| A2018 | PermeaDerm C, per sq cm | 1/1/2024 | Present |
| A2020 | Ac5 Advanced Wound system | 1/1/2024 | Present |
| A2026 | Restrata minimatrix, 5 mg | 4/1/2024 | Present |
| A2027 | Matriderm, per square centimeter | 10/1/2024 | Present |
| A2029 | Mirotract wound matrix sheet, per cubic centimeter | 10/1/2024 | Present |
| A2030 | Miro3d fibers, per milligram | 4/1/2025 | Present |
| A2031 | Mirodry wound matrix, per square centimeter | 4/1/2025 | Present |
| A2034 | Foundation drs solo, per square centimeter | 4/1/2025 | Present |
| A4100 | Skin substitute, FDA cleared as a device, not otherwise specified | 1/1/2024 | Present |
| Q4100 | Skin substitute, fda cleared as a device, not otherwise specified | 1/1/2025 | Present |
| Q4107 | GRAFTJACKET, per sq cm | 1/1/2024 | Present |
| Q4112 | Cymetra, injectable, 1 cc | 1/1/2024 | Present |
| Q4113 | GRAFTJACKET XPRESS, injectable, 1 cc | 1/1/2024 | Present |
| Q4116 | AlloDerm, per sq cm | 1/1/2024 | Present |
| Q4119 | Matristem wound matrix, per square centimeter | 1/1/2025 | Present |
| Q4120 | Matristem burn matrix, per square centimeter | 1/1/2025 | Present |
| Q4125 | ArthroFlex, per sq cm | 1/1/2024 | Present |
| Q4129 | Unite biomatrix, per square centimeter | 1/1/2025 | Present |
| Q4130 | Strattice TM, per sq cm | 1/1/2024 | Present |
| Q4134 | HMatrix, per sq cm | 1/1/2024 | Present |
| Q4135 | Mediskin, per sq cm | 1/1/2024 | Present |
| Q4136 | E-Z Derm, per sq cm | 1/1/2024 | Present |
| Q4138 | BioDFence DryFlex, per sq cm | 1/1/2024 | 12/31/2024 |
| Q4139 | AmnioMatrix or BioDMatrix, injectable, 1 cc | 1/1/2024 | Present |
| Q4140 | BioDFence, per sq cm | 1/1/2024 | 12/31/2024 |
| Q4142 | XCM biologic tissue matrix, per sq cm | 1/1/2024 | Present |
| Q4143 | Repriza, per square centimeter | 1/1/2025 | 3/31/2025 |
| Q4145 | EpiFix, injectable, 1 mg | 1/1/2024 | 6/30/2025 |
| Q4146 | Tensix, per sq cm | 1/1/2024 | Present |
| Q4147 | Architect, Architect PX, or Architect FX, extracellular matrix, per sq cm | 1/1/2024 | 12/31/2024 |
| Q4157 | Revitalon, per sq cm | 1/1/2024 | Present |
| Q4162 | WoundEx Flow, BioSkin Flow, 0.5 cc | 1/1/2024 | 12/31/2024 |
| Q4168 | AmnioBand, 1 mg | 1/1/2024 | Present |
| Q4172 | Puraply or puraply am, per square centimeter | 1/1/2025 | Present |
| Q4174 | PalinGen or ProMatrX, 0.36 mg per 0.25 cc | 1/1/2024 | 12/31/2024 |
| Q4176 | Neopatch or therion, per square centimeter | 1/1/2024 | Present |
| Q4179 | FlowerDerm, per sq cm | 1/1/2024 | Present |
| Q4183 | Surgigraft, per sq cm | 1/1/2024 | Present |
| Q4184 | Cellesta or Cellesta Duo, per sq cm | 1/1/2023 | 3/31/2024 |
| Q4185 | Cellesta Flowable Amnion (25 mg per cc); per 0.5 cc | 1/1/2024 | Present |
| Q4189 | Artacent AC, 1 mg | 1/1/2024 | Present |
| Q4192 | Restorigin, 1 cc | 1/1/2024 | Present |
| Q4198 | Genesis Amniotic Membrane, per sq cm | 1/1/2024 | Present |
| Q4200 | SkinTE, per sq cm | 1/1/2024 | Present |
| Q4202 | Keroxx (2.5 g/cc), 1 cc | 1/1/2024 | Present |
| Q4204 | XWRAP, per sq cm | 1/1/2024 | 2/29/2024 |
| Q4208 | Novafix, per sq cm | 1/1/2024 | Present |
| Q4209 | SurGraft, per sq cm | 1/1/2024 | Present |
| Q4211 | Amnion Bio or AxoBioMembrane, per sq cm | 1/1/2024 | Present |
| Q4212 | AlloGen, per cc | 1/1/2024 | Present |
| Q4214 | Cellesta Cord, per sq cm | 1/1/2024 | Present |
| Q4215 | Axolotl Ambient or Axolotl Cryo, 0.1 mg | 1/1/2024 | Present |
| Q4216 | Artacent Cord, per sq cm | 1/1/2024 | Present |
| Q4218 | SurgiCORD, per sq cm | 1/1/2024 | Present |
| Q4219 | SurgiGRAFT-DUAL, per sq cm | 1/1/2024 | Present |
| Q4220 | BellaCell HD or Surederm, per sq cm | 1/1/2024 | Present |
| Q4224 | Human Health Factor 10 Amniotic Patch (HHF10-P), per sq cm | 1/1/2024 | Present |
| Q4226 | Myown skin, includes harvesting and preparation procedures, per square centimeter | 1/1/2025 | Present |
| Q4228 | Bionextpatch, per square centimeter | 1/1/2025 | Present |
| Q4230 | Cogenex Flowable Amnion, per 0.5 cc | 1/1/2024 | 9/30/2024 |
| Q4231 | Corplex p, per cc | 7/1/2025 | Present |
| Q4233 | SurFactor or NuDyn, per 0.5 cc | 1/1/2024 | Present |
| Q4237 | Cryo-Cord, per sq cm | 1/1/2024 | Present |
| Q4240 | CoreCyte, for topical use only, per 0.5 cc | 1/1/2024 | Present |
| Q4241 | PolyCyte, for topical use only, per 0.5 cc | 1/1/2024 | Present |
| Q4242 | AmnioCyte Plus, per 0.5 cc | 1/1/2024 | Present |
| Q4245 | AmnioText, per cc | 1/1/2024 | Present |
| Q4254 | Novafix DL, per sq cm | 1/1/2024 | Present |
| Q4255 | REGUaRD, for topical use only, per sq cm | 1/1/2024 | Present |
| Q4260 | Signature APatch, per sq cm | 1/1/2024 | Present |
| Q4264 | Cocoon membrane, per square centimeter | 1/1/2024 | 8/31/2024 |
| Q4269 | Surgraft xt, per sq cm | 1/1/2024 | 12/31/2024 |
| Q4270 | Complete sl, per sq cm | 1/1/2024 | 3/31/2025 |
| Q4273 | Esano aaa, per sq cm | 1/1/2024 | Present |
| Q4279 | Vendaje ac, per square centimeter | 1/1/2024 | 12/31/2024 |
| Q4280 | Xcell amnio matrix, per square centimeter | 1/1/2024 | 6/30/2024 |
| Q4284 | Dermabind sl, per sq cm | 1/1/2024 | Present |
| Q4285 | Nudyn dl or nudyn dl mesh, per sq cm | 1/1/2024 | 12/31/2024 |
| Q4286 | Nudyn sl or nudyn slw, per sq cm | 1/1/2024 | 12/31/2023 |
| Q4287 | Dermabind dl, per square centimeter | 1/1/2024 | Present |
| Q4288 | Dermabind ch, per square centimeter | 1/1/2024 | Present |
| Q4289 | Revoshield + amniotic barrier, per square centimeter | 1/1/2024 | 12/31/2024 |
| Q4291 | Lamellas xt, per square centimeter | 1/1/2024 | 12/19/2024 |
| Q4293 | Acesso dl, per square centimeter | 1/1/2024 | 9/30/2024 |
| Q4296 | Rebound matrix, per square centimeter | 1/1/2024 | 9/30/2024 |
| Q4298 | Amnicore pro, per square centimeter | 1/1/2024 | 12/31/2024 |
| Q4299 | Amnicore pro+, per square centimeter | 1/1/2024 | 3/31/2025 |
| Q4300 | Acesso tl, per square centimeter | 1/1/2024 | 9/30/2024 |
| Q4302 | Complete aca, per square centimeter | 1/1/2024 | 9/30/2024 |
| Q4303 | Complete aa, per square centimeter | 1/1/2024 | 3/24/2024 |
| Q4305 | American amnion ac tri-layer, per square centimeter | 4/1/2024 | Present |
| Q4306 | American amnion ac, per square centimeter | 4/1/2024 | Present |
| Q4307 | American amnion, per square centimeter | 4/1/2024 | Present |
| Q4308 | Sanopellis, per square centimeter | 4/1/2024 | Present |
| Q4311 | Acesso, per square centimeter | 7/1/2024 | Present |
| Q4312 | Acesso ac, per square centimeter | 7/1/2024 | Present |
| Q4314 | Reeva ft, per square centimeter | 7/1/2024 | Present |
| Q4315 | Regenelink amniotic membrane allograft, per square centimeter | 7/1/2024 | Present |
| Q4316 | Amchoplast, per square centimeter | 7/1/2024 | Present |
| Q4317 | Vitograft, per square centimeter | 7/1/2024 | Present |
| Q4318 | E-graft, per square centimeter | 7/1/2024 | 6/30/2025 |
| Q4321 | Renograft, per square centimeter | 7/1/2024 | 6/30/2025 |
| Q4322 | Caregraft, per square centimeter | 7/1/2024 | 3/31/2025 |
| Q4323 | Alloply, per square centimeter | 7/1/2024 | 3/31/2025 |
| Q4324 | Amniotx, per square centimeter | 7/1/2024 | 7/2/2024 |
| Q4325 | Acapatch, per square centimeter | 7/1/2024 | 3/31/2025 |
| Q4327 | Duoamnion, per square centimeter | 7/1/2024 | Present |
| Q4328 | Most, per square centimeter | 7/1/2024 | 3/31/2025 |
| Q4329 | Singlay, per square centimeter | 7/1/2024 | Present |
| Q4330 | Total, per square centimeter | 7/1/2024 | Present |
| Q4334 | Amnioplast 1, per square centimeter | 10/1/2024 | Present |
| Q4335 | Amnioplast 2, per square centimeter | 10/1/2024 | Present |
| Q4336 | Artacent c, per square centimeter | 10/1/2024 | Present |
| Q4337 | Artacent trident, per square centimeter | 10/1/2024 | Present |
| Q4338 | Artacent velos, per square centimeter | 10/1/2024 | Present |
| Q4339 | Artacent vericlen, per square centimeter | 10/1/2024 | 6/30/2025 |
| Q4340 | Simpligraft, per square centimeter | 10/1/2024 | 3/31/2025 |
| Q4341 | Simplimax, per square centimeter | 10/1/2024 | 12/31/2024 |
| Q4342 | Theramend, per square centimeter | 10/1/2024 | 12/31/2024 |
| Q4345 | Matrix hd allograft dermis, per square centimeter | 10/1/2024 | 3/3/2025 |
| Q4347 | Rampart dl matrix, per square centimeter | 1/1/2025 | Present |
| Q4357 | Xwrap plus, per square centimeter | 4/1/2025 | 6/30/2025 |
| Q4358 | Xwrap dual, per square centimeter | 4/1/2025 | Present |
| Q4360 | Amchoplast fd, per square centimeter | 4/1/2025 | Present |
| Q4361 | Epixpress, per square centimeter | 4/1/2025 | 6/30/2025 |
| Q4363 | Amnio burgeon membrane and hydromembrane, per square centimeter | 4/1/2025 | Present |
| Q4364 | Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter | 4/1/2025 | Present |
| Q4365 | Amnio burgeon dual-layer membrane, per square centimeter | 4/1/2025 | Present |
| Q4366 | Dual layer amnio burgeon x-membrane, per square centimeter | 4/1/2025 | Present |
| Q4367 | Amniocore sl, per square centimeter | 4/1/2025 | 6/30/2025 |
| Q4368 | Amchothick, per square centimeter | 7/1/2025 | Present |
| Q4369 | Amnioplast 3, per square centimeter | 7/1/2025 | Present |
| Q4370 | Aeroguard, per square centimeter | 7/1/2025 | Present |
| Q4371 | Neoguard, per square centimeter | 7/1/2025 | Present |
| Q4372 | Amchoplast excel, per square centimeter | 7/1/2025 | Present |
| Q4380 | Advograft one, per square centimeter | 7/1/2025 | Present |
| Q4382 | Advograft dual, per square centimeter | 7/1/2025 | Present |