Summary & Overview
HCPCS J1835: Injection, Itraconazole 50 mg
HCPCS Level II code J1835 designates a 50 mg unit of itraconazole administered as an injection. As an antifungal agent used in parenteral therapy, this code is used when billing for the medication component of administered itraconazole in outpatient and office-based infusion settings. Nationally, accurate coding of drug units like J1835 affects payment for infused antifungal therapies and supports clinical documentation for complex infectious disease treatments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the code’s clinical meaning and service settings, payer coverage patterns, common billing modifiers, and practical notes for claim lines that include medication units. The publication also summarizes benchmark considerations for unit-based drug billing and highlights policy updates relevant to HCPCS Level II drug coding and reimbursement procedures.
This summary serves clinicians, billing professionals, and policy analysts seeking a clear, national-level reference for HCPCS Level II code J1835 and the contexts in which itraconazole injections are billed.
Billing Code Overview
HCPCS Level II code J1835 represents an injection of itraconazole, 50 mg. This code denotes administration of the antifungal medication itraconazole in a parenteral form, typically billed per 50 mg unit.
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Service type: Drug administration (intravenous or intramuscular antifungal injection)
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Typical site of service: Infusion center, hospital outpatient department, physician office, or other ambulatory care settings where parenteral medications are administered.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related billing details.
Clinical & Coding Specifications
Clinical Context
A patient with proven or suspected systemic fungal infection requiring intravenous antifungal therapy presents to an outpatient infusion center or inpatient hospital unit. Typical patient is an adult with invasive fungal disease (for example, refractory or severe histoplasmosis, blastomycosis, or other dimorphic fungal infection) or a patient who cannot tolerate or absorb oral itraconazole and requires parenteral formulation. The workflow begins with an infectious disease or pulmonology consult documenting the indication and planned itraconazole injection (J1835) dose. Orders are entered in the electronic medical record with medication administration record (MAR) instructions, appropriate allergy and baseline laboratory checks (liver function tests), and infusion nursing preparation. The medication is reconstituted and administered via intravenous or deep intramuscular route per facility protocol. Nursing documents administration time, site, lot number, and any immediate adverse reaction. Billing staff append the appropriate HCPCS code J1835 to the claim, include relevant CPT procedure codes for infusion services where applicable, and apply clinically appropriate modifiers to reflect unusual circumstances (for example, an unrelated service modifier or modifier indicating a procedure performed on the left or right when applicable). Follow-up includes monitoring hepatic function and clinical response, with repeat doses or transition to oral therapy as clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
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