Summary & Overview
HCPCS S0142: Colistimethate Sodium Inhalation Solution, per mg
HCPCS Level II code S0142 designates colistimethate sodium inhalation solution in a concentrated form, billed per milligram when supplied through durable medical equipment. This code is used to identify the drug product and unit of measure for inhaled colistimethate, a therapy relevant to certain chronic pulmonary infections. Nationally, accurate use of S0142 matters for consistent drug identification, billing transparency for DME-delivered inhalation therapies, and claims processing for payers and providers.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how S0142 is applied in claims for home and outpatient DME settings and summarizes payer coverage considerations at a national level.
Readers will learn: the clinical and billing context for S0142, typical sites of service where the code applies, common modifiers associated with the service (listed separately), and which payers are included in the coverage review. The section on benchmarks and policy will note data limitations where input information is unavailable. This summary is intended to inform billing professionals, revenue cycle teams, and policy analysts working with inhalation DME drug billing.
Billing Code Overview
HCPCS Level II code S0142 represents colistimethate sodium, inhalation solution, concentrated form, billed per mg when administered through durable medical equipment (DME). The code denotes the drug formulation and unit-based billing for inhaled colistimethate in a concentrated solution intended for pulmonary delivery.
Service type: Drug administration via DME (inhalation solution, unit-based)
Typical site of service: Home or outpatient setting where durable medical equipment is used to deliver inhalation therapy, such as patient residence with DME nebulizer or outpatient infusion/respiratory therapy clinic.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with cystic fibrosis or bronchiectasis with chronic Pseudomonas aeruginosa infection receives inhaled colistimethate sodium (S0142) delivered through durable medical equipment (nebulizer). Typical workflow: outpatient pulmonology visit documents recurrent airway colonization, orders inhaled colistimethate sodium in concentrated form by milligram; prescription sent to a specialty pharmacy or DME supplier who prepares and dispenses the concentrated solution; patient receives nurse or respiratory therapist education on nebulizer use, dosing, and infection control; supplies are billed using S0142 per mg when the manufacturer-prepared or compounded concentrated solution is provided for use with home nebulizer equipment. Typical site of service is outpatient clinic, home health setting, or durable medical equipment supplier setting where the inhalation solution is dispensed and patient training occurs. Common patient scenario: an adult or pediatric outpatient with chronic Pseudomonas airway infection prescribed inhaled colistimethate for suppression, provided as a concentrated solution to be used with the patient’s DME nebulizer; follow-up visits occur with the pulmonology team to assess response and tolerance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — No modifier |