HCPCS J3376: Vancomycin HCl (Hikma) Injection, 10 mg

HCPCS Level II code J3376 denotes a 10 mg injection of vancomycin hydrochloride supplied by Hikma and identified as not therapeutically equivalent to J3373. This designation matters nationally because biologic and branded generic distinctions can affect billing, formulary placement, and reimbursement pathways for parenteral antibiotics administered in hospitals and infusion centers. Facilities and payers must distinguish between non-equivalent product codes when processing claims and managing drug inventory.

Key payers commonly involved in coverage and reimbursement for injectable antimicrobials include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks for how this HCPCS Level II drug code is used in clinical infusion settings, an explanation of implications for billing and coding accuracy, and context on when a distinct product-level code (non-therapeutically equivalent) can affect claims processing. The publication also outlines typical sites of service and service type so coders and billing staff can align line-item reporting with clinical administration.

Where input data is missing, this summary indicates that additional payer-specific policy, modifier usage, and diagnosis linkage information is not available in the input and should be sourced from payer policies and facility formularies.

Billing Code Overview

HCPCS Level II code J3376 represents an injection of vancomycin HCl (Hikma), specified as not therapeutically equivalent to J3373, in a 10 mg dose. The service type is an injectable antimicrobial infusion/administration. The typical site of service for this code is acute care settings such as hospital inpatient or outpatient infusion centers, emergency departments, and other clinical settings where parenteral antibiotics are administered.

Data not available in the input.

Clinical Context

A 62-year-old hospitalized patient with a history of chronic kidney disease and recent orthopedic surgery develops signs of a deep surgical site infection with methicillin-resistant Staphylococcus aureus (MRSA) identified on culture. The treating infectious disease physician orders intravenous vancomycin for targeted therapy. Pharmacy provides a branded vancomycin product billed under J3376 (vancomycin HCl, Hikma, 10 mg unit). Nursing prepares the dose, confirms patient identity and allergies, and administers the medication via a peripheral IV or existing central line. Serum trough or area-under-the-curve monitoring is performed per institutional protocol, with dose adjustments by pharmacy or the prescriber. Documentation includes the administered product and dose, lot number, route, time, site of administration, indication (e.g., MRSA bacteremia, osteomyelitis), and any adverse reactions. Billing captures the HCPCS Level II code J3376 for the drug supplied, and facility or professional claims may include infusion administration CPT codes and relevant diagnosis codes for the infection.

Coding Specifications

Modifier	Description	When to Use
`59`	Distinct Procedural Service	When a separate and distinct service is performed on the same day as another procedure (unrelated infusion or procedure) and documentation supports distinctness.

Taxonomy Code	Specialty	Notes
`207L00000X`	Internal Medicine	Hospitalists and internists frequently order and manage IV vancomycin therapy.
`207R00000X`	Infectious Disease	Infectious disease specialists direct antimicrobial selection, dosing strategy, and monitoring.
`363A00000X`	Pharmacy	Clinical pharmacists perform dosing calculations, therapeutic drug monitoring, and IV admixture oversight.
`335000000X`	Nursing — Registered Nurse	Registered nurses administer IV medications, monitor infusion sites, and document administration.
`207K00000X`	Critical Care Medicine	Intensivists manage vancomycin administration in ICU settings for severe infections.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A41.01`	Sepsis due to Methicillin susceptible Staphylococcus aureus	Vancomycin may be used empirically or when MRSA is suspected pending susceptibilities.
`A41.02`	Sepsis due to Methicillin resistant Staphylococcus aureus	Direct indication for IV vancomycin therapy in many cases.
`J15.211`	Pneumonia due to Methicillin resistant Staphylococcus aureus	MRSA pneumonia is a common clinical indication for IV vancomycin.
`M86.172`	Osteomyelitis, right femur, chronic	Deep bone infections due to MRSA often require prolonged IV vancomycin therapy.
`T81.4XXA`	Infection following a procedure, initial encounter	Postoperative infections are an indication for targeted IV antibiotic therapy such as vancomycin.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Often billed for the initial IV infusion event when vancomycin is administered as the primary infusion.
`96366`	Intravenous infusion, each additional hour (list separately in addition to code for primary service)	Used if the infusion extends beyond the initial hour or for longer infusion durations.
`96374`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug	Billed when vancomycin is administered as an IV push (less common; many institutions infuse vancomycin over 60+ minutes).
`36415`	Collection of venous blood by venipuncture	Used for obtaining blood samples for vancomycin serum level monitoring (trough or AUC-based sampling).
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Occasionally used if an alternate route is documented (rare for vancomycin; typically IV).

OpenPayer

Summary & Overview