Summary & Overview
HCPCS S0074: Injection, cefotetan disodium, 500 mg
HCPCS Level II code S0074 represents a 500 mg injection of cefotetan disodium, a parenteral cephamycin antibiotic used in clinical settings for infection management and surgical prophylaxis. Nationally, accurate coding for injectable antibiotics like S0074 matters for clinical documentation, billing consistency, and supply-chain tracking given their use across inpatient and ambulatory care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, billing considerations, and the clinical context in which cefotetan injections are typically billed. The publication outlines common service lines and sites of care where S0074 is used, highlights benchmarking considerations for injectable drug billing, and notes common modifiers and billing complexities that can affect claims adjudication.
The analysis provides operational context for coding teams, revenue cycle managers, and clinicians involved in ordering and administering parenteral antibiotics, summarizing what professionals need to know about HCPCS billing for cefotetan without offering clinical recommendations.
Billing Code Overview
HCPCS Level II code S0074 denotes Injection, cefotetan disodium, 500 mg. This code represents a single-administration pharmaceutical injection of the cephamycin-class antibiotic cefotetan, supplied as a 500 mg dose.
Service Type: Parenteral antibiotic administration (injectable medication)
Typical Site of Service: Hospital inpatient or outpatient settings, ambulatory surgical centers, and other clinical infusion or procedural locations where parenteral antibiotics are administered
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center or hospital perioperative unit who requires prophylactic or therapeutic parenteral antibacterial therapy. The scenario involves administration of S0074 (Injection, cefotetan disodium, 500 mg) as a single-dose preoperative surgical prophylaxis for colorectal or gynecologic surgery, or as part of empiric therapy for intra-abdominal infection when anaerobic coverage is needed. The clinical workflow includes: review of allergies and renal function, preparation of the appropriate number of 500 mg vials to achieve the ordered dose, verification by pharmacy and nursing, intravenous administration (push or infusion) per institutional protocol, and documentation of lot number, amount administered, route, time, and any immediate adverse reaction. Typical sites of service are hospital inpatient wards, same-day surgery units, ambulatory surgical centers, and hospital outpatient infusion centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the administration required substantially greater work or complexity than usual (rare for standard antibiotic injection). |
23 |