Summary & Overview
HCPCS J2186: Meropenem and Vaborbactam Injection, 10mg/10mg (20mg)
HCPCS Level II code J2186 identifies the injectable combination of meropenem and vaborbactam (10mg/10mg per 20mg vial). This drug-level code matters nationally because it captures administration of a targeted carbapenem–beta-lactamase inhibitor therapy used for serious Gram-negative infections, often in acute-care and infusion settings. Accurate coding affects coverage determinations, hospital utilization records, and antimicrobial stewardship reporting.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an orientation to the clinical use and typical sites of service for this agent, a summary of payer coverage considerations and common modifiers, and context for how the code is used on service lines for IV antimicrobial administration. The publication provides benchmarks for billing and utilization where available, outlines recent policy updates impacting coverage and prior authorization practices, and explains implications for hospital and outpatient infusion billing workflows.
This summary is written for a national audience and focuses on coding, clinical context, and payer coverage themes relevant to facilities, coders, and revenue leaders seeking a concise reference for HCPCS Level II code J2186.
Billing Code Overview
HCPCS Level II code J2186 describes the injection of meropenem and vaborbactam, 10mg/10mg (20mg). This entry represents a combined antibacterial and beta-lactamase inhibitor formulation supplied for parenteral administration.
Service Type: Intravenous antimicrobial injection
Typical Site of Service: Hospital inpatient, hospital outpatient infusion center, emergency department, or other infusion settings where IV antibiotics are administered
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old hospitalized patient with a history of complicated urinary tract infection and recent culture demonstrating carbapenem-resistant Enterobacterales is started on parenteral combination therapy. The patient is febrile, has leukocytosis, and requires intravenous targeted antimicrobial therapy with meropenem-vaborbactam. Pharmacy prepares and dispenses the agent for intravenous infusion. Administration occurs in an inpatient acute care unit, observation unit, or outpatient infusion center depending on the clinical stability and site-of-service designation. Nursing documents dose, time, infusion site, and any immediate infusion reactions. Microbiology results, renal function, and therapeutic response guide duration and dosing adjustments. Clinical workflow steps: order entry by prescribing clinician; pharmacy verification and preparation; administration by RN/infusion nurse; monitoring for adverse effects; medication reconciliation and documentation in the medical record; billing using HCPCS code J2186 per single 20 mg unit as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered | Use when part of the vial is discarded and payer requires documentation of wasted drug amount. |