Summary & Overview
HCPCS S0080: Pentamidine Isethionate Injection, 300 mg
HCPCS Level II code S0080 designates a 300 mg injection of pentamidine isethionate, a systemic antimicrobial agent used in specific infectious disease treatment regimens. Nationally, accurate coding for drug injections like S0080 affects claims processing, coverage determinations, and cost reporting for outpatient and ambulatory infusion services. Clear coding is particularly important for infrequent or specialty antimicrobials that may require medical review.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise reference for clinical and billing staff on how this code is used and interpreted across major payer types.
Readers will find an explanation of the clinical service represented by S0080, typical sites of service where the injection is administered, and the broader billing context. The piece outlines common benchmarks and policy considerations relevant to injectable antimicrobials, notes typical modifier usage listed in the input, and identifies where input data are not available. The goal is to give coding, billing, and compliance professionals a practical, national-level summary of HCPCS Level II code S0080 for operational and administrative decision-making.
Billing Code Overview
HCPCS Level II code S0080 represents an injection of pentamidine isethionate, 300 mg. This service is a parenteral antimicrobial administration intended for systemic therapy.
Service Type: Injection/Parenteral Medication Administration
Typical Site of Service: Outpatient clinic, hospital outpatient department, or other ambulatory infusion setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 54-year-old immunocompromised patient with suspected or confirmed Pneumocystis jirovecii pneumonia (PJP) who cannot tolerate trimethoprim-sulfamethoxazole is scheduled to receive an alternative antipneumocystis agent. The care team orders S0080 (injection, pentamidine isethionate, 300 mg) to be administered as an intramuscular or intravenous infusion in an ambulatory infusion center or inpatient medical unit. Pre-procedure workflow includes verification of indication, allergy check, review of current renal and glucose status, premedication considerations, and consent. During administration, nursing documents vital signs, infusion site, medication lot and dose, and monitors for adverse effects (hypotension, nephrotoxicity, hypoglycemia, or dysrhythmia). Post-administration, the patient is observed per facility protocol, labs (renal function, glucose, electrolytes) are reassessed, and medication administration record and billing documentation include S0080, relevant ICD-10 diagnosis, and any applicable modifiers to reflect medical necessity or unusual circumstances. Typical sites of service are an ambulatory infusion center, hospital inpatient unit, emergency department, or skilled nursing facility when clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia |