Summary & Overview
HCPCS J0698: Cefotaxime Sodium Injection, Per Gram
HCPCS Level II code J0698 denotes the supply of cefotaxime sodium for injection, billed per gram. As a third-generation cephalosporin administered intravenously, cefotaxime is used for serious bacterial infections where parenteral therapy is indicated. Nationally, this code matters because it captures the drug component of inpatient and outpatient antimicrobial care and affects hospital medication billing, pharmacy charge capture, and payer drug reimbursement processes.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for cefotaxime use, typical sites of service where the code is applied, and the set of common modifiers associated with injectable drug billing. The publication summarizes benchmarks and policy considerations relevant to billing and coverage for injectable antibiotics, highlights billing practice implications for hospital and ambulatory infusion settings, and lists data elements that were not provided in the input where applicable.
This national-level briefing is intended for revenue cycle leaders, pharmacy directors, billing managers, and policy analysts seeking concise information about HCPCS Level II code J0698, its clinical role, and the payer landscape that governs drug reimbursement.
Billing Code Overview
HCPCS Level II code J0698 represents an injectable formulation of cefotaxime sodium, billed per gram for antimicrobial therapy. This code covers the drug product supplied for intravenous administration and is used when cefotaxime sodium is administered as part of treatment for bacterial infections that require parenteral antibiotic therapy.
Service Type: Injectable antibiotic administration (drug supply)
Typical Site of Service: Hospital inpatient and outpatient settings, emergency department, and ambulatory infusion centers
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult admitted to an inpatient ward or presenting to the emergency department with a moderate-to-severe bacterial infection where a third-generation cephalosporin is indicated. The clinician orders intravenous cefotaxime (J0698) dosed per gram for gram-negative coverage or empiric broad-spectrum therapy pending culture results. Common scenarios include community-acquired pneumonia with sepsis features, complicated urinary tract infection progressing to pyelonephritis, intra-abdominal infection after perforated viscus, and febrile neutropenia in oncology patients. The clinical workflow: initial assessment and diagnosis, obtain cultures (blood, sputum, urine), select empiric IV antibiotic therapy, pharmacy verifies dose and prepares J0698 per gram reconstitution, nursing administers IV push or infusion at the ordered rate, monitor for allergic reaction and therapeutic response, and adjust therapy once culture and sensitivity results return. Documentation includes indication, dose in grams, route, time of administration, lot numbers if required, and modifier use when applicable (e.g., product discarded). Typical sites of service are hospital inpatient, emergency department, observation unit, and outpatient infusion centers for parenteral antibiotic administration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered |