Summary & Overview
HCPCS C9462: Injection, Delafloxacin, 1 mg
HCPCS Level II code C9462 designates the injectable preparation of delafloxacin billed per 1 mg. Delafloxacin is an antibacterial agent used in acute care and outpatient infusion settings; coding this drug separately enables itemized reporting of parenteral antibiotic therapy and supports consistent claims processing. Nationwide, clear HCPCS coding for single-agent injectables matters for accurate reimbursement, utilization tracking, and formulary management.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, common billing practices, and clinical context relevant to delafloxacin injectable use. Readers will find benchmarks for code-level reporting, guidance on typical sites of service where this HCPCS Level II code is used, and a summary of policy considerations that affect billing and claim adjudication. The content highlights common modifiers and administrative elements associated with drug administration billing, while noting when input data are not available. This national overview is intended for health system revenue managers, coding professionals, and policy analysts seeking a concise reference to HCPCS Level II code C9462.
Billing Code Overview
HCPCS Level II code C9462 represents Injection, delafloxacin, 1 mg. This code denotes the drug product delafloxacin provided as an injectable formulation, billed per milligram. Service type: parenteral drug administration. Typical site of service: inpatient hospital, outpatient infusion centers, emergency department, or physician office settings where intravenous or intramuscular antibiotics are administered.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center or emergency department with a diagnosed or strongly suspected acute bacterial skin and skin structure infection (ABSSSI), complicated urinary tract infection (cUTI), or other systemic bacterial infection for which intravenous fluoroquinolone therapy is indicated and delafloxacin is selected based on culture, susceptibility, or penicillin allergy. The patient has been evaluated by an attending physician or advanced practice clinician, has baseline vital signs and allergy history documented, and laboratory testing as indicated (renal function, complete blood count). An order for C9462 (injection, delafloxacin, 1 mg) is placed with the pharmacy specifying dose and frequency; pharmacy dispenses the appropriate mg vial(s). Nursing verifies patient identity, prepares the IV infusion or direct injection per manufacturer instructions, administers the dose, monitors for infusion reactions, documents lot number and expiration, and reports adverse events. Typical workflow includes pre-medication only if prior infusion reactions; observation for 30–60 minutes post-infusion for signs of hypersensitivity; dose adjustments guided by renal function if required; and coordination of follow-up with the prescribing clinician for culture results and transition to oral therapy if appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) |