Summary & Overview
HCPCS Level II J2547: Peramivir Injection, 1 mg
HCPCS Level II code J2547 denotes a 1 mg unit of peramivir administered by injection, an intravenous antiviral used in the treatment of influenza. As a billable drug code, J2547 is relevant to hospital outpatient departments, emergency departments, and infusion centers where parenteral antiviral therapy is provided. Nationally, utilization and coverage of injectable antivirals like peramivir affect acute care treatment patterns and pharmacy spend during influenza seasons and public health responses.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical context, typical sites of service, and payer landscape. The publication summarizes benchmarks and coverage trends, highlights relevant policy updates affecting billing and reimbursement for injectable antivirals, and situates J2547 within clinical workflows for acute influenza management.
The report is designed for health plan managers, hospital billing teams, pharmacy directors, and policy analysts seeking a national perspective on peramivir billing. It presents actionable reference material on where J2547 is billed, common billing considerations, and the broader implications for outpatient and acute-care pharmacy services.
Billing Code Overview
HCPCS Level II code J2547 represents an injection of peramivir, 1 mg. This drug is an antiviral agent administered parenterally for the treatment of influenza. The service type is injectable antiviral therapy, typically delivered as an intravenous infusion or bolus depending on clinical protocol. The typical site of service is outpatient infusion centers, hospital outpatient departments, emergency departments, or other acute care settings where parenteral antiviral administration is performed.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting during influenza season with acute onset of fever, myalgias, cough, or dyspnea who is assessed in an emergency department, urgent care, or inpatient setting and found to meet criteria for antiviral therapy with an intravenous neuraminidase inhibitor. Peramivir (J2547) is administered as a single-dose intravenous infusion when oral or inhaled antivirals are not appropriate (for example, inability to tolerate oral agents, gastrointestinal malabsorption, or clinical severity requiring parenteral therapy). The clinical workflow includes triage and history, influenza testing (rapid antigen or PCR) and/or clinical diagnosis, review of allergies and renal function, informed consent, preparation of the peramivir dose by pharmacy, IV placement by nursing, administration and observation for infusion-related reactions, documentation of lot number and units administered, and billing with J2547 reported per milligram with applicable modifiers. Typical sites of service are hospital inpatient wards, emergency departments, observation units, and some outpatient infusion centers or urgent care centers offering IV antivirals.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard use when no modifier applies |