HCPCS Code Details - Q4133

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q4133
Description

Long description:
Grafix prime and grafixpl prime, per square centimeter

Short description:
Grafix prime grafix pl prime

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 C - Change in long description of procedure or modifier code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2018
Date added Added Jan 01, 2013
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 - Q4133

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2018 - December 31, 2018 1 SQ CM 131.794 - - - - - -
July 1, 2018 - September 30, 2018 1 SQ CM 132.486 - - - - - -
April 1, 2018 - June 30, 2018 1 SQ CM 133.912 - - - - - -
January 1, 2018 - March 31, 2018 1 SQ CM 134.284 - - - - - -
October 1, 2017 - December 31, 2017 1 SQ CM 138.877 - - - - - -

See also

  • HCPCS Q4132 · Grafix core and grafixpl core, per square centimeter

  • HCPCS Q4134 · Hmatrix, per square centimeter


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”