Summary & Overview
HCPCS Level II J2804: Injection, Rifampin, 1 mg
HCPCS Level II code J2804 designates the injectable antibiotic rifampin measured per 1 mg unit. As a unit-based drug code used across outpatient and clinic infusion settings, it matters nationally for billing of parenteral antimicrobial therapy, inventory tracking, and payer coverage determinations for infectious disease management. Payers commonly involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication summarizes what J2804 represents clinically and operationally, outlines typical sites of service, and highlights the kinds of benchmarks and policy details readers will find: national billing benchmarks and utilization context for injectable rifampin; payer coverage considerations and common modifier usage; and clinical context for use of rifampin in bacterial infections where parenteral administration is indicated. Where specific input fields are not provided, the report notes "Data not available in the input." The content is intended for billing managers, revenue cycle staff, and clinical leaders seeking a concise reference to how HCPCS Level II code J2804 is used in practice and in payer interactions.
Billing Code Overview
HCPCS Level II code J2804 describes an injection of rifampin, 1 mg. This code represents the billed drug unit for administering rifampin in injectable form. The service type is injectable antimicrobial therapy, and the typical site of service is outpatient infusion or clinic-based injection administration, including ambulatory care settings where parenteral antibiotics are given.
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Clinical & Coding Specifications
Clinical Context
A patient prescribed rifampin for an infectious indication presents to an ambulatory infusion clinic or inpatient unit for medication administration. Typical indications include treatment of active tuberculosis as part of multi-drug therapy, management of certain staphylococcal prosthetic device infections in combination regimens, or prophylaxis for meningococcal exposure when oral administration is not feasible. The medication is supplied as an injectable formulation billed with J2804 (injection, rifampin, 1 mg). The clinical workflow begins with physician order and verification of indication and allergy history, baseline liver function tests reviewed for hepatotoxicity risk, consent and counseling for potential drug interactions and discoloration of bodily fluids, preparation of the correct dose by pharmacy, and administration by a registered nurse via intramuscular or intravenous route per facility policy. Post‑administration monitoring includes assessment for immediate infusion reactions and documentation of lot number, expiration, dose, route, and site. For outpatient prophylaxis, administration may occur in an urgent care or public health clinic; for TB treatment, dosing is commonly coordinated with directly observed therapy in public health settings or specialty clinics. Billing uses J2804 with appropriate modifiers to reflect service circumstances such as multiple procedures, unusual services, or administrative distinctions.
Coding Specifications
| Modifier | Description | When to Use |
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