Summary & Overview
HCPCS Level II J0697: Injection of Cefuroxime Sodium, 750 mg
HCPCS Level II code J0697 describes the injectable antibiotic cefuroxime sodium, billed per 750 mg. As a commonly used parenteral cephalosporin, this code represents a discrete drug supply line item important for hospital, outpatient, emergency, and clinic billing. Accurate use of J0697 affects claims processing, inventory tracking, and aggregate drug spend reporting across payer programs nationally.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines national benchmarks and common payer coverage practices, highlights coding and billing considerations for drug line items, and places J0697 in clinical context for parenteral antibiotic therapy.
Readers will learn the clinical description and typical sites of service tied to J0697, what standard coverage environments are for injectable cefuroxime, and which metrics and benchmarks are commonly used when evaluating utilization and reimbursement of parenteral antibiotics. Data not available in the input is noted where applicable. This summary provides concise reference material for revenue cycle, coding, and clinical teams managing injectable drug billing at scale.
Billing Code Overview
HCPCS Level II code J0697 represents an injection of sterile cefuroxime sodium, billed per 750 mg. This service is an antibiotic injectable administration used to treat or prevent bacterial infections when intravenous or intramuscular cefuroxime is indicated.
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Service type: Injectable antibiotic medication
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Typical site of service: Hospital inpatient, hospital outpatient, emergency department, ambulatory surgical center, or clinic settings where parenteral antibiotic therapy is administered
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center, emergency department, or hospital inpatient unit with a suspected or confirmed bacterial infection where parenteral second‑generation cephalosporin therapy is indicated. The clinician diagnoses conditions such as community‑acquired pneumonia, uncomplicated skin and soft tissue infection, urinary tract infection requiring IV therapy, or perioperative prophylaxis for moderate‑risk procedures. The workflow: clinician evaluates the patient, orders IV antibiotic therapy, pharmacy prepares a sterile dose of cefuroxime sodium in a 750 mg vial or appropriate multiple vials to reach the ordered dose, nursing verifies allergies and consent, obtains IV access, administers the reconstituted cefuroxime per facility protocol (bolus or infusion), monitors for adverse reaction during and after administration, documents lot numbers and vial counts, and applies appropriate billing with J0697 for each 750 mg unit administered and relevant modifiers to reflect circumstances such as partial vials, administration setting, or discontinuation due to adverse reaction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered | When part of a single-use vial is discarded and payer requires reporting of wasted drug amount. |