Summary & Overview
HCPCS J0692: Injection, Cefepime Hydrochloride 500 mg
HCPCS Level II code J0692 denotes the injection of cefepime hydrochloride, 500 mg, a parenteral fourth‑generation cephalosporin used for serious bacterial infections. Nationally, this code is relevant for facilities and clinicians delivering intravenous antimicrobial therapy across outpatient infusion centers, emergency departments, and inpatient units. Use of J0692 affects revenue cycle workflows, medical necessity review, and antimicrobial stewardship practices.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, common billing and coding considerations, and how J0692 is applied across sites of service.
Readers will find benchmarks on typical utilization and payment contexts, summaries of relevant policy updates impacting HCPCS drug coding and reimbursement, and clinical context describing the medication and usual administration settings. Where input data is incomplete, the report notes "Data not available in the input." The intent is to provide concise, national-level guidance on administrative and clinical aspects associated with HCPCS Level II code J0692.
Billing Code Overview
HCPCS Level II code J0692 represents an injection of cefepime hydrochloride, 500 mg. This code describes the administration of a fourth-generation cephalosporin antibiotic formulated as a 500 mg injectable dose.
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Service type: Parenteral antimicrobial therapy
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Typical site of service: Ambulatory infusion center, outpatient clinic, emergency department, or inpatient hospital setting
Data not available in the input regarding associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult hospitalized with a suspected or confirmed severe Gram-negative bacterial infection (for example, healthcare-associated pneumonia, complicated urinary tract infection, intra-abdominal infection, or sepsis) who requires intravenous broad-spectrum antipseudomonal beta-lactam therapy. The treating physician orders J0692 (injection, cefepime hydrochloride, 500 mg) to be administered by a registered nurse in an inpatient medical ward, step-down unit, or emergency department observation area. The clinical workflow includes verification of the order, review of allergies and renal function, pharmacy preparation and dose adjustment if renal impairment is present, bedside administration via IV push or infusion per facility protocol, documentation of lot number and expiration, monitoring for infusion reactions, and daily reassessment for de-escalation based on culture and sensitivity results.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug discarded/not administered to any patient | When partial vial contents are wasted and the discarded drug amount must be reported for single-use vial drugs. |
JZ |