HCPCS Code Details - Q4102

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q4102
Description

Long description:
Oasis wound matrix, per square centimeter

Short description:
Oasis wound matrix

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2014
Date added Added Jan 01, 2009
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - Q4102

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2024 - December 31, 2024 1 SQ CM 12.252 - - - - - -
Jul 1, 2024 - Sep 30, 2024 1 SQ CM 11.791 - - - - - -
April 1, 2024 - June 30, 2024 1 SQ CM 12.417 - - - - - -
January 1, 2024 - March 31, 2024 1 SQ CM 13.407 - - - - - -
October 1, 2023 - December 31, 2023 1 SQ CM 12.5 20% - - - - -

See also


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”