Summary & Overview
HCPCS Level II J3090: Injection, tedizolid phosphate, 1 mg
HCPCS Level II code J3090 denotes a 1 mg unit of tedizolid phosphate administered parenterally. Tedizolid is an oxazolidinone-class antibiotic used to treat certain bacterial infections and its dosing is commonly reported per milligram for accurate drug billing and inventory tracking. Nationally, accurate reporting of drug J-codes like J3090 matters for claims processing, drug cost management, and drug utilization monitoring across acute care and infusion settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage considerations and common billing practices for injectable antibiotics across major commercial and public payers.
Readers will learn the clinical context for using J3090, where the service is typically delivered, and what operational benchmarks and policy updates to watch for related to injectable antimicrobial billing. The report includes billing benchmarks, coding nuances for unit reporting, and payer policy summaries to inform revenue cycle and clinical operations teams. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
HCPCS Level II code J3090 represents injection, tedizolid phosphate, 1 mg. This billing code is used to report administration of the antibiotic tedizolid phosphate in a measured milligram unit.
Service type: parenteral antimicrobial administration — the code denotes a medication dose for injectable or IV/IM delivery.
Typical site of service: hospital inpatient, hospital outpatient, infusion center, emergency department, or other facility-based settings where parenteral antimicrobials are administered.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center, hospital inpatient ward, or emergency department with a confirmed or suspected serious gram-positive bacterial infection resistant to other agents, such as methicillin-resistant Staphylococcus aureus (MRSA) or complicated skin and soft tissue infection (cSSTI). The clinician prescribes parenteral tedizolid phosphate for patients who require intravenous therapy—often as a switch therapy from oral administration when the patient is unable to tolerate oral intake, has gastrointestinal absorption concerns, or requires inpatient-level monitoring. The workflow includes medication order entry (including J3090 billed per milligram), pharmacist verification and preparation of the injectable formulation, IV or IM administration by a registered nurse, monitoring for infusion reactions and hematologic adverse effects, documentation of dose and lot number, and transition planning to oral therapy when clinically appropriate. Typical sites of service are outpatient infusion centers, inpatient hospital units, and emergency departments. Payors commonly involved in authorization and reimbursement processes include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier reported | Use as a default when no other modifier applies to the service |