Acknowledgement:

Information on reimbursement in the United States is provided as a courtesy. Due to the rapidly changing nature of the law and Medicare payment policy, and our reliance on information provided by outside sources, the information provided herein does not constitute a guarantee or warranty by Smith and Nephew,Inc that reimbursement will be received.

This information is provided "AS IS" and without any other warranty or guarantee, expressed or implied, as to completeness or accuracy or otherwise. This information has been compiled based on data gathered from many primary and secondary sources, including the American Medical Association and certain Medicare contractors.

Physicians and other providers must confirm or clarify coding and coverage from their respective payers, as each payer may have differing formal or informal coding, coverage policies, or decisions. Physicians and providers are responsible for accurate documentation of patient conditions, and for reporting of procedures and products in accordance with particular payer requirements.

Reimbursement


HCPCS Codes for Products

The HCPCS codes for OASIS® Wound Matrix (Q4102) and OASIS® Ultra Tri-Layer Matrix (Q4124) remain the same for 2016. CMS has indicated that these brand-specific HCPCS codes are applicable for all sites of service that use the OASIS® Matrix products.

  • When required and/or appropriate, report the name of the product, its size, its product number, and the invoice price per piece in the appropriate field of a paper claim or in the narrative field of an electronic claim
  • The descriptions for HCPCS codes Q4102 and Q4124 refer to "per square centimeter"
    Examples:
    3 cm x 3.5 cm = 10.5 sq cm
    3 cm x 7 cm = 21 sq cm
    5 cm x 7 cm = 35 sq cm
    7 cm x 10 cm = 70 sq cm
    7 cm x 20 cm = 140 sq cm
  • Qualified healthcare professionals (QHPs) should document and report the number of square centimeters used and discarded for each application. The Medicare program provides payment for the amount of the drug or biological discarded as well as the dose administered, up to the amount of the drug or biological as indicated on the vial or package label

OASIS® is a registered trademark of Cook Biotech, Inc.
CPT® is a registered trademark of the American Medical Association.




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OASIS is a registered trademark of Cook Biotech, Inc.
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