Summary & Overview
HCPCS Level II J2291: Nafcillin Sodium Injection, 20 mg
HCPCS Level II code J2291 denotes a 20 mg injectable dose of nafcillin sodium (Baxter), an antistaphylococcal penicillin used for treatment of susceptible bacterial infections. As an HCPCS Level II drug code, J2291 is used on medical claims to identify the specific drug and dosage administered in clinical settings. Accurate reporting of this code matters nationally because it affects drug utilization tracking, payer coverage determinations, and payment for parenteral antibiotic therapy across hospitals and ambulatory care sites.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the drug formulation and typical sites of service, along with coverage and billing considerations relevant to these major payers. The publication outlines typical benchmarks and common modifiers used with HCPCS drug codes, summarizes payer coverage patterns where available, and highlights billing best practices and documentation expectations tied to injectable medications.
This resource is intended for revenue cycle and clinical staff, coders, and policy analysts seeking a concise reference for J2291 usage, payer considerations, and the administrative context for parenteral nafcillin sodium dosing. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code J2291 represents an injection of nafcillin sodium (Baxter), 20 mg. The service is an antibiotic injection intended for intravenous or intramuscular administration to treat susceptible bacterial infections. Typical site of service is inpatient hospital, outpatient hospital, or other ambulatory settings where parenteral antibiotic therapy is administered.
Service type: Injectable drug administration.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 56-year-old male presents to the emergency department with fever, localized erythema, swelling and purulent drainage at the site of a recent surgical incision. The clinician evaluates for postoperative wound infection and orders parenteral nafcillin sodium for empiric intravenous therapy targeting methicillin-sensitive Staphylococcus aureus (MSSA). The medication is supplied as J2291 (Injection, nafcillin sodium, 20 mg) and is prepared by pharmacy and administered by nursing in the ED or inpatient ward. Typical workflow includes medication order entry, allergy verification, dose calculation based on weight and renal/hepatic function, IV administration (bolus or intermittent infusion), monitoring for infusion reactions, documentation of lot number and expiration, and coordination with microbiology for culture results to de-escalate therapy when appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no special circumstances apply to the service |
22 | Increased procedural services | Use when substantially greater effort or resources are required for medication administration (document increased work) |