Summary & Overview
HCPCS Level II J0287: Amphotericin B Lipid Complex Injection, 10 mg
HCPCS Level II code J0287 designates the injection of amphotericin B lipid complex, 10 mg, a formulation used for systemic antifungal therapy. The code is important for accurate billing of intravenous antifungal infusions in hospital and infusion center settings and for national tracking of utilization and spending on specialty antifungal agents. Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. This publication provides a concise overview of clinical context, billing and coding considerations, and payer coverage patterns. Readers will find national benchmarks for service lines using J0287, common billing modifiers and claims handling observations, and a summary of clinical indications where lipid-complex amphotericin B is used. The brief also outlines typical sites of service and operational considerations for infusion delivery. Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific policy language.
Billing Code Overview
HCPCS Level II code J0287 describes the injection of amphotericin B lipid complex, 10 mg. This code is used to report administration of the lipid-complex formulation of amphotericin B, an antifungal agent delivered via intravenous injection.
Service type: Intravenous antifungal therapy
Typical site of service: Hospital inpatient or outpatient infusion center
Clinical & Coding Specifications
Clinical Context
A 58-year-old immunocompromised patient with proven systemic invasive fungal infection (for example, refractory candidemia or invasive aspergillosis) is admitted to the hospital after failing or being intolerant to conventional amphotericin B deoxycholate or first-line antifungal azoles. The infectious disease team recommends administration of J0287 (Injection, amphotericin B lipid complex, 10 mg) as part of systemic antifungal therapy. The medication is prepared by pharmacy in weights-based dosing, transported to the inpatient unit or infusion center, and administered intravenously via a central line or peripheral IV under nursing supervision. Vital signs and renal function are monitored before and during therapy due to potential nephrotoxicity and infusion-related reactions. Typical documentation includes indication, dose in milligrams, lot number, route, site of administration, start and stop times, and any adverse reactions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or outpatient visit | When the drug is administered in an outpatient clinic visit setting where an evaluation and management visit is performed |
22 |