Summary & Overview
HCPCS J2248: Micafungin Sodium Injection, 1 mg
HCPCS Level II code J2248 denotes a 1 mg injection of micafungin sodium, an intravenous echinocandin antifungal used to treat serious fungal infections. Nationally, accurate use of J2248 matters for billing of parenteral antifungal therapy across acute care and outpatient infusion settings, where micafungin is commonly administered for candidemia and invasive candidiasis. Proper coding supports clinical documentation, utilization tracking, and payer adjudication for high-cost biologic antimicrobial agents.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common sites of service for micafungin administration, and the kinds of benchmarks and policy topics typically relevant to injectable antifungals—such as reimbursement benchmarks, coverage considerations, and coding practice implications. Where specific input data are missing, the report notes "Data not available in the input." The publication is intended to inform billing professionals, revenue cycle managers, and clinicians about the coding and administrative context for micafungin injections at a national level.
Billing Code Overview
HCPCS Level II code J2248 represents an injection of micafungin sodium, 1 mg. This code is used to report administration of the antifungal agent micafungin, dosed per milligram.
Service type: Parenteral antimicrobial administration
Typical site of service: Hospital inpatient, hospital outpatient infusion center, or ambulatory infusion clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a hospitalized adult with suspected or proven invasive candidiasis or other serious systemic fungal infection requiring intravenous echinocandin therapy. A common scenario is a patient in an acute care hospital with sepsis and positive blood cultures for Candida species, or an intensive care unit patient with neutropenia and persistent fever despite broad-spectrum antibacterial therapy. The physician orders micafungin sodium dosed by weight; pharmacy dispenses J2248 units corresponding to the required milligrams; nursing administers the infusion via peripheral or central intravenous line, often once daily. Monitoring includes clinical response, liver function tests, and infusion site assessment. Documentation in the medical record includes indication (e.g., candidemia), dose and total milligrams administered, lot number and expiration of the vial, route (IV), infusion start/stop times, and any medication waste documented with modifier JW if applicable. Typical site of service is inpatient acute care hospital or outpatient infusion center for complex patients; the service type is drug administration of an antifungal agent billed as HCPCS Level II injectable drug, reported per milligram using the J2248 unit of 1 mg of micafungin sodium.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW |