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PalinGen Dual-Layer Membrane

PalinGen Dual-Layer Membrane

PalinGen Dual-Layer Membrane

Technology and Product Assessment
Product Type: Human Skin Allografts
Other related products
Unbiased information for educational purposes only. WoundReference does not produce, market, advertise, re-sell or distribute healthcare goods or services consumed by, or used on patients. For information about specific products, please contact the manufacturer directly.

PalinGen® Dual-Layer Membrane is regulated as a human cell, tissue, or cellular or tissue-based product (HCT/P)

INTENDED USES: PalinGen® Membrane provides a wound covering and support for native tissues. Indicated for full and partial-thickness, acute, and chronic wounds.

CLAIMED BENEFITS: PalinGen® Membrane provides a biological and physical overlay to support and protect the wound in vivo. Resorbable. Chorion-free. Sterile (gamma irradiated). Air dried

OPTIONS: Available sizes

DL-020203: PalinGen Dual-Layer Membrane, 2x3 cm: Q4354

DL-020204: PalinGen Dual-Layer Membrane, 2x4 cm: Q4354

DL-020404: PalinGen Dual-Layer Membrane, 4x4 cm: Q4354

DL-020406: PalinGen Dual-Layer Membrane, 4x6 cm: Q4354

DL-020408: PalinGen Dual-Layer Membrane, 4x8 cm: Q4354

DLX-020203: PalinGen Dual-Layer Membrane, 2x3 cm: Q4354

DLX-020404: PalinGen Dual-Layer Membrane, 4x4 cm: Q4354

DLX-020406: PalinGen Dual-Layer Membrane, 4x6 cm: Q4354

DLX-020408: PalinGen Dual-Layer Membrane, 4x8 cm: Q4354

Manufacturer: Amnio Technology
Information retrieved from manufacturer and/or FDA-approved labels
* Wound Reference does not produce, market, re-sell or distribute health care goods or services consumed by, or used on, patients. The product information contained on this page, including the product images and additional product materials, was collected from various supplier sources. All product claims and specifications are those of the product suppliers. Every effort has been made to ensure the accuracy of the product information, however on occasion manufacturers may alter their products or packaging without notice. Wound Reference assumes no liability for inaccuracies or misstatements about products. The properties of a product may change or be inaccurate following the posting or printing of the product information in the document, either in the print or online version. Due to product changes, information listed in this document is subject to change without notice. We recommend that you always read labels, warnings and instructions for use before using a product. Content on this site is for reference purposes and is not intended to be a substitute for professional advice given by a physician or other licensed healthcare professional.

ESSENTIALS

Product
Estimated
Out-of-pocket
Cost
HCPCS Class
HCPCS
Palingen dual-layer membrane, per square centimeter
Palingen dual-layer membrane, per square centimeter
Palingen dual-layer membrane, per square centimeter
Q4354
* Hover on the information button next to each header for detailed explanation on the type of information provided by the table
Select your state for Medicare
DME coverage and co-payment
Product
Estimated
Out-of-pocket
Cost
Patient DME Co-Payment per Billable Unit
DME Reimbursement to Suppliers
Frequency Replacement if Requirements Met
Office and/or Facility - Product reimbursement
Palingen dual-layer membrane, per square centimeter
Amnio Technology
Palingen dual-layer membrane, per square centimeter
$.00
Coming soon
* Every effort has been made to ensure the accuracy of the product information, however you should visit the manufacturer's website for the latest information.
* Hover on the information button next to each header for detailed explanation on the type of information provided by the table
Product
Estimated
Out-of-pocket
Cost
Recom / Evidence
FDA Safety
Quality Measures
Cost Effectiveness
Palingen dual-layer membrane, per square centimeter
Palingen dual-layer membrane, per square centimeter
361 HCT/P
Coming soon
Coming soon
Product
Estimated
Out-of-pocket
Cost
Features
Palingen dual-layer membrane, per square centimeter
Palingen dual-layer membrane, per square centimeter
No CPT codes to display.
  • Hover on the information button next to each header for detailed explanation on the type of information provided by the table
  • The information provided on this website is informational only. This is not a guarantee of Reimbursement Rates, nor is it intended to make recommendations regarding clinical practices. Information on this website is subject to change with out notice due to changes in reimbursement laws, regulations, rules and policies. The ultimate responsibility for correct coding lies with the provider of services. Please contact the appropriate payer for their interpretation of the appropriate code to use for the procedure.
  • CPT® is a registered trademark of the American Medical Association. All CPT codes and descriptions are copyrighted 2018, American Medical Association. All rights reserved. CPT codes and CPT descriptions are from the current manuals and those included herein are not intended to be all-inclusive and are included for informational purposes only. Codes referenced on Wound Reference are for informational purposes only. Inclusion or exclusion of any codes does not guarantee coverage. Providers should reference the American Medical Association prior to the submission of claims for reimbursement of covered services.
* Scroll table to see all products.

CLINICAL

FDA

Regulated under PHS 361 [21 CFR 1270 & 1271]: Human cells, tissues, and cellular and tissue-based products.

CODING, COVERAGE AND REIMBURSEMENT

This section currently focuses primarily on Medicare. It may be expanded in the future to include information on private insurers as well.  


Frequency of replacement allowed by Medicare



Medicare Administrative Contractor (MAC)Frequency of replacement if requirements met

Novitas Solutions, Inc.

CGS Administrators, LLC

First Coast Service Options, Inc. (FCSO)

Palmetto

Noridian

Wisconsin Physicians Service Insurance Corporation (WPS)

National Government Services, Inc. (NGS)

Carrier discretion


More details on requirements, medical necessity and documentation in specific Medicare Local Coverage Determinations (if available). See section on Coding, Coverage and Reimbursement in topic "Cellular and/or Tissue Products". 

Official reprint from WoundReference® woundreference.com ©2026 Wound Reference, Inc. All Rights Reserved
Use of WoundReference is subject to the Subscription and License Agreement. ​
NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.
Topic 3262 Version 1.0

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