Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

This Billing and Coding Article clarifies billing, coding, and documentation requirements for amniotic and placental-derived product injections/applications for non-wound musculoskeletal indications under LCD L39877. Claims reporting HCPCS A4100 or Q4100 must include product name, amount injected, and amount wasted, and those HCPCS codes must not be used with injectable skin substitutes; denial of the product may cause denial of associated same-day injection/application services. All medical records must be legible, include patient identifiers, dates of service, and the responsible provider's signature, and must support the ICD-10-CM and CPT/HCPCS codes billed.

"Coverage applies when the amniotic or placental-derived product injection/application meets the reasonable and necessary requirements of Local Coverage Determination L39877."

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