Summary & Overview
HCPCS C9446: Injection, tedizolid phosphate, 1 mg
HCPCS Level II code C9446 identifies a unit of the injectable antibiotic tedizolid phosphate (1 mg). This code matters nationally as it enables consistent billing for a newer oxazolidinone-class antibiotic used in serious Gram-positive infections where parenteral therapy is required. Accurate coding supports appropriate reimbursement, utilization monitoring, and formulary management across outpatient infusion centers, hospital outpatient departments, and physician office settings.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what C9446 denotes, how it is used in clinical and billing workflows, and the national payer landscape relevant to injectable antibiotic claims. The publication summarizes benchmarks for coverage and payment where available, highlights policy considerations affecting access and billing for parenteral antibiotics, and provides clinical context for when tedizolid phosphate may be administered.
This summary is intended to inform coding professionals, revenue cycle staff, and policy analysts about the role of HCPCS Level II code C9446 in outpatient injectable drug billing and the payer environments that commonly process claims for this medication. Data not available in the input.
Billing Code Overview
HCPCS Level II code C9446 represents Injection, tedizolid phosphate, 1 mg. The service type for this code is drug administration / injectable antibiotic supply. The typical site of service is outpatient infusion or clinic-based injectable administration, including hospital outpatient departments and physician offices where parenteral antibiotics are provided.
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Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a recent episode of complicated skin and soft tissue infection caused by gram-positive organisms is evaluated in an outpatient infusion clinic for antibiotic therapy. After culture and susceptibility results identify an oxazolidinone-susceptible organism and the patient is intolerant of linezolid due to prior adverse effects, the infectious disease clinician prescribes tedizolid phosphate administered as an intravenous injection. The clinic nurse prepares C9446 (Injection, tedizolid phosphate, 1 mg) and documents medication administration in the electronic health record. Typical workflow steps include: medication order verification by the pharmacist, informed consent and assessment of allergies and baseline labs (CBC, hepatic panel), IV access placement or verification of existing access, administration of the appropriate milligram dose using the billed units of C9446, monitoring for infusion reactions, and documentation of dose, lot number, and site of service. The Typical Site of Service is an outpatient infusion center or ambulatory clinic; inpatient administration may occur in acute care when clinically indicated. Patient follow-up includes monitoring for hematologic or neurologic adverse effects and assessment of clinical response to therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |