Summary & Overview
HCPCS Level II J0278: Injection, Amikacin Sulfate, 100 mg
HCPCS Level II code J0278 designates a 100 mg injection of amikacin sulfate, an intravenous or intramuscular aminoglycoside antibiotic used for serious gram-negative infections. Nationally, accurate coding for parenteral antibiotics like J0278 matters for clinical documentation, drug utilization tracking, and claims processing across outpatient and hospital settings. This code applies to single-dose drug reporting and is relevant for facilities and clinicians administering injectable antimicrobials.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find practical information on the clinical context of amikacin use, common sites of service where J0278 is billed, and the payer landscape that affects coverage and claim adjudication. The publication outlines standard benchmarks and policy-relevant considerations for billing injectable antibiotics, highlights coding nuances affecting reimbursement workflows, and summarizes typical administrative practices for reporting single-dose parenteral drugs.
Where specific data elements were not provided in the input, the publication states that those items are not available. The focus remains national in scope, addressing coding clarity and operational implications for clinicians, billing teams, and administrators dealing with parenteral antibiotic services.
Billing Code Overview
HCPCS Level II code J0278 represents an injection of amikacin sulfate, 100 mg. This billing code is used for the administration of the aminoglycoside antibiotic amikacin in a parenteral formulation.
Service Type: Injectable antibiotic administration
Typical Site of Service: Outpatient clinic, physician office, or hospital outpatient department
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a documented gram-negative bacterial infection requiring aminoglycoside therapy, such as complicated urinary tract infection, bacteremia, or respiratory tract infection caused by susceptible organisms. The medication J0278 (amikacin sulfate 100 mg injection) is administered in an outpatient infusion clinic, emergency department, hospital inpatient unit, or skilled nursing facility. Clinical workflow: the prescriber documents indication, weight-based dosing, renal function and baseline audiology/vestibular assessment when relevant; pharmacy prepares and labels the single-dose vial or syringe; nursing verifies identity, allergy status, and renal dosing, then administers via intramuscular or intravenous route per protocol; monitoring includes vital signs, renal function tests (serum creatinine), and hearing/vestibular symptoms during a multi-dose course. Documentation includes medication administration record, indication, dose, route, lot number, and any adverse reactions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug discarded/not administered to any patient | Use when partial vial contents are discarded and billed per unit for single-use vial waste reporting. |