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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j3485-zidovudine-injection-10mg
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    HCPCS Level II J3485: Injection, zidovudine 10 mg

    HCPCS Level II code J3485 represents an injection of zidovudine 10 mg, a single-dose parenteral antiretroviral medication administered as an intravenous or intramuscular injection for treatment or prophylaxis of HIV infection; the service type is medication administration and the typical site of service is an outpatient clinic, hospital outpatient department, or infusion center where injectable antiretroviral therapies are provided.

    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), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with HIV infection requiring antiretroviral therapy who presents to an outpatient infusion clinic, emergency department, or inpatient ward for parenteral administration of zidovudine due to inability to tolerate or absorb oral therapy, acute gastrointestinal illness, perioperative fasting, or when rapid antiviral plasma levels are clinically indicated. The clinical workflow begins with a physician or advanced practice clinician order for J3485 (injection, zidovudine, 10 mg). Nursing verifies indication, allergies, recent labs (including hemoglobin, neutrophil count, and liver function tests), obtains informed consent when required, prepares the dose (calculating total mg required and number of vials), performs appropriate venous access or uses existing IV/IM route, administers the injection, monitors for immediate adverse reactions (hypersensitivity, hematologic toxicity), documents lot number and expiration, and records administration in the medical record and on the medication administration record (MAR). Billing staff append appropriate modifiers to J3485 to reflect payer requirements, splitting of units, or special circumstances, and link the administration to a primary HIV diagnosis such as B20 when applicable or other infection-related diagnoses in the charting and claims submission.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularOften billed when J3485 is administered via IM or SC route and an administration code is required in addition to the drug HCPCS.
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourUsed when zidovudine is administered as part of an IV infusion session lasting up to one hour.
    96366Intravenous infusion; each additional hourUsed when IV administration of zidovudine extends beyond the initial hour.
    36415Collection of venous blood by venipuncturePerformed when pre-administration labs (CBC, CMP, viral load) are drawn to assess safety prior to dosing.
    99499Unlisted evaluation and management serviceOccasionally used for atypical or bundled services related to complex medication administration when no specific CPT code exists.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    367H00000XAnesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    2081H0002XHospice and Palliative Medicine (Physical Medicine & Rehabilitation) PhysicianA physical medicine and rehabilitation physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with l…
    111NR0400XRehabilitation ChiropractorRehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are d…
    126900000XDental Laboratory TechnicianAn individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laborator…
    103G00000XClinical NeuropsychologistA clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to norma…

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 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
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    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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