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    v1.0.30
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0133-acyclovir-injection-5mg
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    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS Level II code J0133 describes a 5 mg injection of acyclovir, a systemic antiviral medication; the service is the administration of acyclovir as an injectable dose, typically provided in outpatient infusion centers, hospital outpatient departments, or clinic settings where parenteral antivirals are delivered.

    For related coverage guidance, see recent payer policy updates: Hematology - Adzynma, Tumor Treating Fields for Pancreatic Cancer, Axicabtagene ciloleucel (Yescarta®) coverage.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult presenting to an outpatient infusion center or emergency department with an acute severe herpesvirus infection (for example, disseminated herpes simplex virus or severe varicella-zoster in an immunocompromised patient) requiring intravenous antiviral therapy. The treating clinician (infectious disease specialist, emergency physician, hospitalist, or oncology/hematology team) orders IV acyclovir dosed by weight. Pharmacy compounds the supply using J0133 billed per 5 mg unit and prepares the infusion or bolus. Nursing documents medication administration, vital signs, infusion reaction monitoring, and renal function assessments before and during therapy due to acyclovir’s nephrotoxicity risk. Typical workflow steps: clinician order → pharmacy verification and dose calculation → IV preparation and labeling → bedside administration with appropriate modifier usage for billing (for example, outpatient service, emergency department service, or modifier to indicate drug wastage) → documentation of indication, dose, lot number, and patient response in the medical record.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, hydration; initial, 31 minutes to 1 hourMay be billed when IV acyclovir is administered as an infusion requiring documented time and infusion setup in the outpatient setting.
    96366Intravenous infusion, each additional hour (list separately in addition to code for primary infusion)Used when acyclovir infusion continues beyond the initial hour and time-based infusion reporting is permitted.
    90471Immunization administration (not directly related)Data not applicable; included only when concurrent vaccine administration occurs — otherwise not typically related.
    36415Collection of venous blood by venipunctureOften performed before or during IV antiviral therapy for renal function and viral testing.
    87480Infectious agent detection by nucleic acid (e.g., HSV PCR)Diagnostic testing commonly performed to confirm herpes simplex or varicella-zoster infection guiding IV acyclovir use.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207R00000X
    207L00000X
    208800000X
    111NX0100X
    273100000X
    1835P2201X
    246YC3302X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    A49.9Bacterial infection, unspecified
    A85.8Other specified viral encephalitis
    B00.1Herpesviral vesicular dermatitis
    B00.2Herpesviral gingivostomatitis and pharyngotonsillitis
    B00.3Herpesviral meningitis
    B00.4Herpesviral encephalitis
    B00.9Herpesviral infection, unspecified
    B01.0Varicella meningitis
    B01.2Varicella pneumonia

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Hematology - AdzynmaCigna2026-10-15
    Tumor Treating Fields for Pancreatic Cancerselect_health2026-10-01
    Axicabtagene ciloleucel (Yescarta®) coverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Kansas Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Idaho Only)UnitedHealthcare2026-10-01
    Brexucabtagene autoleucel (Tecartus) CoverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Factor VIII ProductsCigna2026-09-15

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    HCPCS-J0135-ADALIMUMAB-20MG-INJECTION

    HCPCS Level II J0135: Injection, adalimumab, 20 mg

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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