Summary & Overview
HCPCS Q0144: Azithromycin dihydrate 1 g oral
HCPCS Level II code Q0144 represents azithromycin dihydrate, oral, capsules/powder, 1 gram. This single-dose oral antibiotic formulation is used in outpatient settings for specific infectious indications and is notable for its convenience and adherence advantages in ambulatory care. Nationally, accurate coding of oral antibiotic formulations affects pharmacy billing, claims adjudication, and outpatient antimicrobial utilization reporting.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for a 1-gram azithromycin preparation, typical sites of service, and the implications for billing workflows. The publication outlines common billing considerations, payer coverage patterns where available, and benchmark-focused content relevant to pharmacy and outpatient billing teams.
The content covers: the clinical description and typical use cases for a 1-gram oral azithromycin product; payer coverage summary for major national payers; and guidance on what information is and is not available in the presented input. Data not provided in the input (such as specific payer coverage policies, ICD-10 pairings, modifiers usage frequencies, or related codes) is noted as unavailable.
Billing Code Overview
HCPCS Level II code Q0144 denotes azithromycin dihydrate, oral, capsules/powder, 1 gram. This code represents a single-dose oral antibiotic formulation commonly used for targeted infectious disease treatments where a 1-gram dose of azithromycin is indicated.
Service Type: Oral antimicrobial therapy
Typical Site of Service: Outpatient pharmacies, clinic-administered oral medication, or other outpatient care settings
Data not available in the input for other fields.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an urgent care clinic or outpatient primary care office with symptoms of acute bacterial infection such as suspected sexually transmitted infection (e.g., chlamydia), community-acquired otitis media, or certain soft tissue infections where a single-dose oral macrolide is appropriate. The clinician performs a focused history and physical, documents the indication and any allergies, and may obtain point-of-care testing (e.g., NAAT for chlamydia/gonorrhea) or cultures as indicated. When a single 1 gram oral dose of azithromycin is selected, the medication is dispensed or administered in-office with documentation of the lot number, route (oral), and dosing. For billing, the product is reported with HCPCS Level II code Q0144 for azithromycin dihydrate, oral, capsules/powder, 1 gram. Common payer interactions include verifying coverage for pharmacy-dispensed versus in-office supplied medication and appending an appropriate modifier when billing circumstances require it (for example, modifier 25 if a significant, separately identifiable evaluation and management service was provided the same day). Typical sites of service are outpatient clinic, urgent care, emergency department, or community sexual health clinics where single‑dose oral therapy is delivered.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |