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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j3095-telavancin-injection-10mg
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    HCPCS J3095: Telavancin Injection, 10 mg

    HCPCS Level II code J3095 represents a billed drug product for telavancin injection, 10 mg, used for intravenous antimicrobial therapy; the service is a drug administration typically provided in inpatient hospital or outpatient infusion settings depending on clinical need and ordering provider.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old hospitalized patient with a documented Gram-positive complicated skin and soft tissue infection (such as methicillin-resistant Staphylococcus aureus) and significant comorbidities (chronic kidney disease stage 3 and diabetes mellitus) requires intravenous antibacterial therapy. The inpatient infectious diseases team evaluates the patient and determines telavancin is appropriate based on pathogen susceptibility, prior antibiotic exposure, and clinical severity. The medication J3095 (Injection, telavancin, 10 mg) is prepared by pharmacy and administered by a registered nurse via peripheral IV or central line in the inpatient acute care setting. Documentation includes indication, dose (calculated per weight and renal function), infusion rate, lot number, vial waste if any, and administration modifiers such as JW for discarded drug when applicable. Monitoring includes vital signs, renal function tests, and assessment for infusion-related reactions; dose adjustments are made for renal impairment. The clinical workflow typically involves order entry by the prescribing physician, pharmacy verification and compounding, bedside administration by nursing with MAR documentation, and billing using J3095 with appropriate units to reflect the total milligrams administered.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipuncturePerformed before or during therapy for baseline and monitoring labs (renal function, therapeutic drug monitoring).
    36416Collection of capillary blood specimen (e.g., finger, heel)Used for point-of-care glucose or other capillary monitoring while inpatient receiving therapy.
    36556Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or olderMay be performed if reliable central venous access is required for repeated IV antibiotic administration.
    99070Supplies and materials (except spectacles), used directly by the patientBilled for additional non-covered supplies used during administration when payor rules permit.
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourUsed to report administration time-based infusion services when telavancin infusion duration meets reporting criteria.
    96366Intravenous infusion, each additional hour (List separately in addition to code for primary service)Used to report additional infusion time beyond the initial hour when clinically required.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    261QV0200XVA Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    1835X0200XOncology PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in developing, recommending, implementing, monitoring, and modifying pharma…
    225XM0800XMental Health Occupational TherapistOccupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
    207RI0011XInterventional Cardiology PhysicianAn area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and p…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    A41.01Sepsis due to Methicillin susceptible Staphylococcus aureus
    A41.4Sepsis due to anaerobes
    A41.51Sepsis due to Escherichia coli [E. coli]
    A41.9Sepsis, unspecified organism
    A49.1Streptococcal infection, unspecified site
    A49.8Other bacterial infections of unspecified site
    B96.4Proteus (mirabilis) (morganii) as the cause of diseases classified elsewhere
    G00.9Bacterial meningitis, unspecified
    H66.90Otitis media, unspecified, unspecified ear
    I82.409Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Chimeric Antigen Receptor (CAR) T-Cell TherapyColorado Rocky Mountain Health Plans2026-08-01
    Allogeneic Hematopoietic Progenitor Cell TherapyAmbetter Georgia2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Idaho Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for New Jersey Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Ohio Only)UnitedHealthcare2026-08-01
    Reblozyl (luspatercept-aamt) Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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