Summary & Overview
HCPCS Level II J0348: Injection, Anidulafungin, 1 mg
HCPCS Level II code J0348 denotes the injectable antifungal anidulafungin measured per 1 mg unit. The code is used to bill for parenteral administration of anidulafungin in acute care and outpatient infusion settings, where management of serious invasive fungal infections occurs.
This national overview covers major commercial and public payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise context on the clinical application of anidulafungin, typical settings of service, and the billing construct of a per-milligram HCPCS Level II code. The publication outlines what to expect from payer coverage policies and reimbursement practices at a high level and summarizes common billing considerations tied to medication administration lines.
The piece also identifies relevant benchmarking and policy topics for stakeholders: unit-based drug coding, site-of-service implications for infusion therapy, and payer coverage variability for expensive antifungal agents. Data not provided in the source are noted as unavailable and are not extrapolated.
Billing Code Overview
HCPCS Level II code J0348 represents an injection of anidulafungin, 1 mg. This code is used for billing the administration of the antifungal agent anidulafungin in a quantified unit of 1 mg.
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Service type: Parenteral medication administration (intravenous antifungal therapy)
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Typical site of service: Hospital inpatient settings, hospital outpatient departments, infusion centers, and other clinical settings where intravenous antifungal therapy is delivered
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A hospitalized adult patient with documented invasive candidiasis (for example, candidemia or intra-abdominal candidiasis) requires antifungal therapy with an echinocandin. Pharmacy prepares J0348 (anidulafungin, 1 mg) as an intravenous infusion dose based on weight (typical dosing: 200 mg IV loading dose followed by 100 mg IV daily for many adults). The clinical workflow includes infectious disease consultation, order entry in the electronic medical record, medication compounding in the sterile pharmacy, bedside IV administration by registered nursing, and monitoring for infusion reactions and liver function tests. Documentation in the medical record includes indication, dose and lot numbers, route (IV), start and stop times, patient consent if applicable, and treatment response. This service commonly occurs in acute inpatient settings (medical wards, intensive care units) and occasionally in outpatient infusion centers for step-down therapy when clinically appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug discarded/unused portions of single-dose vial | When part of the vial drug is discarded and reporting of discarded drug is required for billing reconciliation |
QK |