HCPCS J0122: Injection, Eravacycline, 1 mg
HCPCS Level II code J0122 identifies a 1 mg unit of eravacycline supplied for injection. As an intravenous antibiotic, eravacycline is used in clinical settings to treat certain serious bacterial infections; accurate coding of the drug units is essential for claims processing, inventory tracking, and cost analysis across hospital and outpatient infusion sites. Nationally, consistent use of J0122 supports standardized billing for eravacycline administration and aids payers and providers in reconciling drug acquisition and patient care costs.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of how the code is applied in clinical workflows, the common sites of service where eravacycline is administered, and what to expect in payer coverage context. The publication also outlines typical benchmarks and policy considerations relevant to drug unit coding, reimbursement implications for high-cost infused antibiotics, and related billing and documentation practices. Where specific data elements from payers or additional coding crosswalks are not provided in the input, the text notes that those items are not available.
Sign up for hcpcs J0122 policy alerts
Get alerted when payer policies referencing J0122 are released or updated.
Billing Code Overview
HCPCS Level II code J0122 represents an injection of eravacycline, 1 mg. This code describes the drug product and the administered unit of medication for intravenous infusion or injection as indicated by the drug description.
Service Type: Intravenous antibiotic administration
Typical Site of Service: Hospital inpatient, hospital outpatient infusion center, or other outpatient infusion settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult hospitalized for a complicated intra-abdominal or severe community-acquired bacterial infection who requires intravenous broad-spectrum therapy. Eravacycline is administered as an intravenous infusion prepared from the J0122 billing unit (injection, eravacycline, 1 mg). The clinical workflow begins with infectious disease consultation and selection of eravacycline when pathogens or clinical risk factors (multidrug-resistant Gram-negative organisms, prior antibiotic exposure, or intolerance to other agents) warrant its use. Pharmacy compounds the exact dose based on patient weight and renal/hepatic status, labels the vial(s), and documents lot numbers. Nursing verifies the order, obtains intravenous access (peripheral or central), performs bedside time-out, and administers the infusion per institutional protocol (typically over 60 minutes depending on preparation). Post-infusion monitoring includes vital signs, assessment for infusion reactions, and documentation of dose, units administered (milligrams via J0122), and any adverse events. Billing captures J0122 units corresponding to the milligrams administered, with applicable modifiers for circumstances such as professional service, administration complexity, or discarded medication per standards.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug discarded/not administered to patient | Use when portion of a single-use vial is discarded and payer requires reporting of discarded biologic/chemotherapeutic agents. |
JZ | No drug wastage (entire amount administered) | Use when the full amount of the vial(s) was administered with no discard. |
CQ | Service furnished under a qualified nonphysician practitioner’s ordering (Medicare) | Use when a nurse practitioner or physician assistant orders/administers under applicable rules. |
QX | Services performed by a practitioner with a physician’s arrangement (QHP modifier) | Use when required for billing split/shared or other non-physician arrangements per payer rules. |
QY | Service furnished under physician supervision of auxiliary personnel | Use when infusion is performed by auxiliary personnel under direct physician supervision when required. |
62 | Two surgeons | Use rarely when two attending physicians of different specialties are required for complex vascular/central access placement associated with therapy. |
78 | Return to OR for related procedure during postoperative period | Use if a surgical procedure related to access or complications occurs returning to the operating room. |
80 | Assistant surgeon | Use when an assistant surgeon is involved in placing access required for administration. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist — primary | Use when an advanced practice clinician is the primary provider for the infusion encounter and payer requires this modifier. |
11 | Professional component | Use when billing only professional services related to interpretation or supervision distinct from the drug billing. |
22 | Increased procedural services | Use when administration required substantially greater effort or complexity than typical (documented justification required). |
23 | Unusual anesthesia — medically necessary, patient not medically stable for local anesthesia | Use when anesthesia is required for access placement or infusion and situation meets payer criteria. |
52 | Reduced services | Use when less than the full service was provided (e.g., infusion stopped early for documented clinical reasons). |
53 | Discontinued procedure | Use when the infusion or associated procedure was started but discontinued due to an adverse event or clinical instability. |
78 | (listed above) Return to OR — included here for relevance to access complications |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 360400000X | Infectious Disease | Specialists who select, monitor, and manage use of eravacycline for complex infections. |
| 207Q00000X | Emergency Medicine | Providers initiating IV antibiotics for severe infections prior to admission. |
| 363L00000X | Pharmacy | Clinical pharmacists involved in dosing, compounding, and documentation of intravenous antibiotics. |
| 274K00000X | Hospitalist | Providers managing inpatient ordering, monitoring, and coordination of antimicrobial therapy. |
| 364S00000X | Nursing (General) | Registered nurses responsible for IV administration and bedside monitoring. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A41.9 | Sepsis, unspecified organism | Eravacycline may be selected for severe systemic infections caused by resistant Gram-negative organisms when broad-spectrum coverage is needed. |
K65.9 | Peritonitis, unspecified | Complicated intra-abdominal infections, including peritonitis, are common indications for eravacycline therapy. |
K35.80 | Acute appendicitis with peritoneal abscess | Complicated intra-abdominal infections following appendicitis may require IV eravacycline. |
A49.9 | Bacterial infection, unspecified | Empiric broad-spectrum therapy may be initiated for serious bacterial infections pending culture data. |
J18.9 | Pneumonia, unspecified organism | Severe hospital-acquired or healthcare-associated pneumonias with multidrug-resistant organisms may prompt use of eravacycline in selected cases. |
N39.0 | Urinary tract infection, site not specified | Complicated urinary tract infections due to resistant pathogens can be an indication for IV broad-spectrum agents. |
B96.89 | Other specified bacterial agents as the cause of diseases classified elsewhere | Used as a supplemental code to identify specific bacterial pathogens when known and relevant to antibiotic selection. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | Commonly billed for the administration time of the first-hour eravacycline infusion in an outpatient infusion center or clinic. |
96366 | Intravenous infusion, each additional hour (List separately in addition to code for primary infusion) | Billed when eravacycline infusion exceeds one hour or for prolonged infusion or observation time. |
36415 | Collection of venous blood by venipuncture | Performed prior to or during therapy for baseline labs, therapeutic drug monitoring, or culture draws. |
36556 | Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older | Performed if central access is required for prolonged or vesicant therapy related to administration. |
99070 | Supplies and materials (except spectacles), noncovered items or services; used by provider | Billed for additional disposable supplies used during infusion when payers allow separate supply charges. |