{"id":183232,"date":"2026-08-18T07:52:01","date_gmt":"2026-08-18T07:52:01","guid":{"rendered":"https:\/\/pabau.com\/?p=183232"},"modified":"2026-08-18T07:52:04","modified_gmt":"2026-08-18T07:52:04","slug":"hcpcs-code-j2407","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j2407\/","title":{"rendered":"HCPCS code J2407: Oritavancin (Orbactiv) billing guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"HCPCS code J2407: Oritavancin (Orbactiv) billing guide\",\"description\":\"J2407 covers oritavancin per 10 mg, so a 1,200 mg Orbactiv dose bills as 120 units. Here's what else the claim needs.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j2407\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-07\",\"dateModified\":\"2026-08-18\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>HCPCS code J2407 covers injection of oritavancin (Orbactiv) in 10 mg increments, billed under Medicare Part B in outpatient settings.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The FDA-approved dose is a single 1,200 mg infusion, which bills as 120 units of J2407.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The drug code does not pay for the infusion, so the administration codes belong on the same claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Medicare pays J2407 under ASP plus 6%, and most commercial payers want prior authorization before the infusion date.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau links the infusion record to the claim, so billed units match the dose given.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">HCPCS code J2407 is the Level II code for injection of oritavancin, the antibiotic sold as Orbactiv, billed per 10 mg administered. A standard 1,200 mg dose therefore bills as 120 units.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Four errors cause most J2407 denials:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The wrong unit count on the claim line<\/li>\n\n\n\n<li>No supporting ABSSSI diagnosis in the record<\/li>\n\n\n\n<li>Missing or expired prior authorization<\/li>\n\n\n\n<li>A place-of-service code that does not match the setting<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This guide covers each one, along with the administration codes that belong on the same claim as the drug.<\/p>\n\n\n\n<h2 id=\"h-hcpcs-code-j2407-code-description-and-drug-details\" class=\"wp-block-heading\">HCPCS code J2407: Code description and drug details<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">J2407 is the HCPCS Level II code assigned to injection of oritavancin, sold as Orbactiv, in increments of 10 mg. It sits in the J-code series, which CMS uses to classify injectable drugs given in outpatient settings. Because oritavancin is dosed by milligram, the units you bill follow the milligrams administered.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The table below sets out the core code attributes coders need before touching a claim form.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Attribute<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">HCPCS Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J2407<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, oritavancin (Orbactiv), 10 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">HCPCS Level II, J-code (injectable drug)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Drug brand name<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbactiv (oritavancin diphosphate)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Drug class<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lipoglycopeptide antibiotic<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billing unit<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Per 10 mg administered<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Maintained by<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS (Centers for Medicare and Medicaid Services)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Coverage pathway<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicare Part B (outpatient only)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-clinical-use-what-oritavancin-treats\" class=\"wp-block-heading\">Clinical use: What oritavancin treats<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Oritavancin is FDA-approved to treat acute bacterial skin and skin structure infections, known as ABSSSI, caused by gram-positive organisms. That includes methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus pyogenes, and related pathogens. Billing J2407 for a non-approved indication invites both denial and compliance exposure.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What makes the drug distinctive for billing teams is its single-dose administration. Most antibiotics for serious skin infections need multi-day inpatient courses. Oritavancin delivers the full course in one 3-hour infusion. That is why it lands in outpatient infusion centers and physician offices.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Any practice already running <a href=\"https:\/\/pabau.com\/industry\/iv-therapy-emr-software\/\">IV therapy software<\/a> will recognize the workflow. Drug preparation, line setup, infusion monitoring, and documentation all happen inside one visit. That outpatient model is also why Medicare Part B covers J2407, while Part A does not. The drug is never bundled into an inpatient DRG payment.<\/p>\n\n\n\n<h2 id=\"h-j2407-billing-units-calculating-the-dose\" class=\"wp-block-heading\">J2407 billing units: Calculating the dose<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The FDA-approved dose of oritavancin is 1,200 mg, given as a single IV infusion. Since J2407 is billed per 10 mg, a full course bills as 120 units. Practices with disciplined <a href=\"https:\/\/pabau.com\/blog\/best-emr-for-iv-therapy\/\">IV therapy EMR<\/a> records rarely get this wrong, but it remains the most common J2407 error.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Unit calculation formula:<\/strong> Total mg administered divided by 10 mg per unit.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Dose administered<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Units per unit descriptor (10 mg)<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Units to bill<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">1,200 mg (the FDA-approved dose)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">120 units<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">800 mg (illustrative arithmetic, not a labeled dose)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">80 units<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">600 mg (illustrative arithmetic, not a labeled dose)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">60 units<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Only the 1,200 mg regimen appears on the Orbactiv label. The 800 mg and 600 mg rows show how the arithmetic works, not an approved regimen. If a prescriber orders anything other than 1,200 mg, bill the milligrams actually given.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Billing 120 units when 800 mg was given is a compliance problem. Record the administered dose in the infusion note and carry that number straight onto the claim. The same per-milligram arithmetic governs other injectable J-codes, including <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j2323\/\">J2323<\/a>.<\/p>\n\n\n\n<h2 id=\"h-what-else-goes-on-the-claim-with-j2407\" class=\"wp-block-heading\">What else goes on the claim with J2407<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">J2407 pays for the drug only. The infusion itself is a separate administration service with its own codes. A 3-hour Orbactiv infusion is normally reported as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-96365\/\">CPT code 96365<\/a> for the first hour, plus two units of 96366 for the additional hours.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Leaving the administration codes off the claim gives away payment for three hours of chair time and nursing. Coders who submit the J-code alone see the drug reimbursed and the visit unpaid.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Wastage modifiers are the other question that comes up. Orbactiv ships as three 400 mg vials that are fully administered, so nothing is discarded. According to Orbactiv&rsquo;s reimbursement guide, CMS does not list J2407 among the codes tied to single-dose containers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That means the JW and JZ modifiers generally do not apply here. Confirm it with your Medicare Administrative Contractor before you standardize the rule, because local guidance varies.<\/p>\n\n\n\n<h2 id=\"h-medicare-fee-schedule-and-reimbursement-rates\" class=\"wp-block-heading\">Medicare fee schedule and reimbursement rates<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare pays J2407 under the Part B drug methodology, average sales price (ASP) plus 6%. The per-unit rate changes every quarter as CMS republishes the ASP pricing files. Check the current quarter&rsquo;s amount in the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">Physician Fee Schedule lookup<\/a> before the claim goes out.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hard-coding a fixed dollar amount per unit is how practices end up under-collecting for a whole quarter without noticing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">ASP plus 6% applies when oritavancin is given incident-to in a physician office. In a hospital outpatient department the rate follows the Outpatient Prospective Payment System (OPPS) instead. Check which payment system governs the encounter before you price the claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For programmatic checks, the <a href=\"https:\/\/clinicaltables.nlm.nih.gov\/apidoc\/hcpcs\/v3\/doc.html\" target=\"_blank\" rel=\"nofollow noopener\">Clinical Table Search API<\/a> confirms that J2407 is active and billable for a given claim date.<\/p>\n\n\n\n<h2 id=\"h-j2407-place-of-service-and-coverage-settings\" class=\"wp-block-heading\">J2407 place of service and coverage settings<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The place-of-service (POS) code on a J2407 claim drives both the payment rate and the coverage pathway. Oritavancin is not an inpatient Part A drug, so it is only billable in an outpatient or office setting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Anyone <a href=\"https:\/\/pabau.com\/blog\/how-to-open-an-iv-therapy-clinic\/\">opening an infusion practice<\/a> needs the POS code settled before the first claim. The table below lists the eligible settings.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">POS code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payment system<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Physician office<\/td>\n<td style=\"padding:12px 16px;color:#374151\">11<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Part B (ASP+6%)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Outpatient hospital<\/td>\n<td style=\"padding:12px 16px;color:#374151\">22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">OPPS (rate varies)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Ambulatory infusion center<\/td>\n<td style=\"padding:12px 16px;color:#374151\">24<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Part B (ASP+6%)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Inpatient hospital<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Not separately billable under Part B<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">If the patient is admitted while receiving oritavancin, the drug cost folds into the inpatient DRG payment. J2407 cannot then be billed separately under Part B. Hospital-based infusion departments hit this more often than freestanding centers do.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Verify the patient&rsquo;s admission status before billing J2407. An observation patient is outpatient and qualifies for Part B drug billing. An admitted inpatient does not. Request the admission status from the facility or the ordering team before the claim drops.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-prior-authorization-requirements\" class=\"wp-block-heading\">Prior authorization requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Traditional Medicare Part B does not require prior authorization for J2407. Most Medicare Advantage plans and commercial payers do. The per-infusion cost makes oritavancin a standing target for medical-necessity review, so treat prior authorization as the commercial default.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What payers usually ask for before they approve:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A confirmed ABSSSI diagnosis with supporting clinical documentation<\/li>\n\n\n\n<li>Culture and sensitivity results, or a note explaining why cultures were not obtained<\/li>\n\n\n\n<li>Medical necessity for single-dose IV therapy over oral or multi-day IV alternatives<\/li>\n\n\n\n<li>Prescriber details and site-of-care justification<\/li>\n\n\n\n<li>The NDC confirming Orbactiv rather than Kimyrsa, which uses J2406<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">A ready-made <a href=\"https:\/\/pabau.com\/templates\/medical-prior-authorization-form\/\">prior authorization form<\/a> saves the front desk rebuilding the same packet for every payer. Requirements shift by plan year, so confirm status before the infusion date rather than after it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Submitting without an authorization number when the payer requires one produces a denial. Appeals on high-cost injectables are slow, and <a href=\"https:\/\/pabau.com\/blog\/timely-filing-limits\/\">timely filing limits<\/a> keep running while you gather paperwork.<\/p>\n\n\n\n<h2 id=\"h-j2407-documentation-requirements\" class=\"wp-block-heading\">J2407 documentation requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Documentation for a J2407 claim has to support medical necessity, confirm the administered dose, and tie the drug to a diagnosis. Holding drug administration records to <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-software\/\">HIPAA-compliant standards<\/a> also protects the practice in an audit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What a complete J2407 record contains:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>ABSSSI diagnosis:<\/strong> the clinical note establishes the infection, its extent, and gram-positive involvement<\/li>\n\n\n\n<li><strong>Prescriber order:<\/strong> a signed order naming oritavancin and the intended dose<\/li>\n\n\n\n<li><strong>Infusion record:<\/strong> date, start and stop times, dose in milligrams, route, and the administering clinician&rsquo;s signature<\/li>\n\n\n\n<li><strong>Culture results or justification:<\/strong> lab findings, or a note explaining the empiric therapy decision<\/li>\n\n\n\n<li><strong>Medical necessity statement:<\/strong> why single-dose IV therapy was chosen over oral or standard IV regimens<\/li>\n\n\n\n<li><strong>NDC:<\/strong> the National Drug Code for Orbactiv, confirming J2407 rather than J2406<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">Digital intake forms<\/a> that capture infusion details at the point of care beat reconstructing them a week later. The infusion record is the most-requested document in a J2407 audit, and a <a href=\"https:\/\/pabau.com\/blog\/clean-claim\/\">clean claim<\/a> depends on it.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-j2407\/customizable-consent-and-intake-forms.webp\" alt=\"Customizable consent and intake forms in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s customizable forms let you capture the infusion dose, route, and times while the patient is still in the chair.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-applicable-icd-10-diagnosis-codes-for-j2407-claims\" class=\"wp-block-heading\">Applicable ICD-10 diagnosis codes for J2407 claims<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every J2407 claim needs an ICD-10-CM diagnosis code that establishes medical necessity. The codes below map to ABSSSI, the approved indication for Orbactiv, and come from the <a href=\"https:\/\/icd10cmtool.cdc.gov\/\" target=\"_blank\" rel=\"nofollow noopener\">CDC&rsquo;s ICD-10-CM tool<\/a>. Verify them against the current fiscal year&rsquo;s release, since codes are added and deleted annually.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L03.011<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cellulitis of right finger<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L03.012<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cellulitis of left finger<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L03.211<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cellulitis of face<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L03.311<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cellulitis of abdominal wall<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L02.01<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cutaneous abscess of face<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L02.211<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cutaneous abscess of abdominal wall<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">A41.01<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Sepsis due to methicillin susceptible Staphylococcus aureus (MSSA)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">A41.02<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Sepsis due to methicillin resistant Staphylococcus aureus (MRSA)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">B95.62<\/td>\n<td style=\"padding:12px 16px;color:#374151\">MRSA as cause of disease classified elsewhere<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">L08.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pyoderma<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Code to the site the record documents. Practices using <a href=\"https:\/\/pabau.com\/industry\/dermatology-emr-software\/\">dermatology EMR software<\/a> see the L03 and L02 ranges most often. Picking an abdominal wall code for a documented leg infection is the mismatch auditors pull first.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Watch the sepsis pair too. A41.01 covers MSSA sepsis and A41.02 covers MRSA sepsis, so the two are not interchangeable on a claim.<\/p>\n\n\n\n<h2 id=\"h-j2407-vs-j2406-understanding-the-difference\" class=\"wp-block-heading\">J2407 vs J2406: Understanding the difference<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Oritavancin is marketed as Orbactiv and as Kimyrsa. Both carry the same active molecule, but each product has its own NDC and its own HCPCS code. Billing the wrong one for the administered product is a coding error a payer can treat as a false claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/features\/prescription-management-software\/\">Drug administration tracking<\/a> that records the NDC at the point of care flags a code mismatch before the claim leaves the building. The comparison below sets the two codes side by side.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-j2407\/prescribe-controlled-drugs-safely-and-stay-compliant.webp\" alt=\"Prescribing and drug administration records in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau records the prescribed product and its NDC against the patient file, so the brand on the label matches the code on the claim.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Attribute<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">J2407<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">J2406<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Active ingredient<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Oritavancin<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Oritavancin<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Brand name<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbactiv<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Kimyrsa<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">HCPCS code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J2407<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J2406<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billed per unit<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">NDC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbactiv-specific NDC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Kimyrsa-specific NDC<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billing rule<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bill J2407 only when Orbactiv was administered<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bill J2406 only when Kimyrsa was administered<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The NDC on the claim must match the packaging of the product administered. If pharmacy supply switches from Orbactiv to Kimyrsa, the billing code switches from J2407 to J2406.<\/p>\n\n\n\n<h2 id=\"h-common-billing-errors-and-how-to-avoid-them\" class=\"wp-block-heading\">Common billing errors and how to avoid them<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Four errors account for most J2407 rejections, and each has a checkpoint that catches it.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Unit miscalculation:<\/strong> billing 12 units instead of 120 for a 1,200 mg dose. It usually happens when milligrams get typed into a units field. Add one checkpoint, where infusion-record milligrams divided by 10 must equal the units billed.<\/li>\n\n\n\n<li><strong>Wrong POS code:<\/strong> POS 21 on an outpatient infusion encounter, or POS 11 on a hospital outpatient visit. Both produce rate mismatches and avoidable denials.<\/li>\n\n\n\n<li><strong>Missing or expired prior authorization:<\/strong> a payer that waived PA last year may require it at renewal. Check status before every infusion, not once at setup.<\/li>\n\n\n\n<li><strong>Diagnosis mismatch:<\/strong> a general cellulitis code where the note documents an abscess, or a right-side code against left-side pathology.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Reading the remittance advice matters as much as preventing the error. Learning the <a href=\"https:\/\/pabau.com\/blog\/denial-codes-in-medical-billing\/\">denial codes<\/a> your payers use tells you which of the four went wrong on any given claim.<\/p>\n\n\n\n<h2 id=\"h-commercial-payer-and-medicaid-rate-variation\" class=\"wp-block-heading\">Commercial payer and Medicaid rate variation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare&rsquo;s ASP plus 6% is the steadiest benchmark for J2407, but commercial rates move around it. Some plans pay a percentage of average wholesale price. Others use a negotiated contract rate above or below the Medicare figure. State Medicaid rates are often lower than Medicare for high-cost injectables.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">No lookup tool replaces the contract. For a commercial claim, pull the plan&rsquo;s fee schedule or ask provider relations to confirm the J2407 rate before the infusion. Practices tracking this properly fold it into <a href=\"https:\/\/pabau.com\/blog\/what-is-revenue-cycle-management\/\">revenue cycle management<\/a> rather than checking claim by claim.<\/p>\n\n\n\n<h2 id=\"h-how-pabau-keeps-j2407-units-and-documentation-aligned\" class=\"wp-block-heading\">How Pabau keeps J2407 units and documentation aligned<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most infusion practices keep the dose in one place and the claim in another. A nurse writes 1,200 mg in the infusion note, then a biller reads it off a printout and types units into the billing system. Every hand-off is a chance for 120 to become 12.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau keeps both in the same record. The infusion note, the prescriber order, the NDC, and the diagnosis code sit on the file the claim is built from. Pabau&rsquo;s <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> then carries those details onto the claim line.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">So there are fewer trips back to the chart when a payer asks what was given and why. <a href=\"https:\/\/pabau.com\/case-studies\/esteem-life-medical-group\/\">Esteem Life Medical Group<\/a> uses Pabau to keep its records and compliance in one place.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-j2407\/automate-claims-through-healthcode.webp\" alt=\"Pabau claims management dashboard\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s claims management tools submit and track billing claims from the same record that holds the infusion note.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Track drug administration and billing units in one place                <\/h3>\n\n                <p class=\"description\">\n                    Pabau helps infusion and IV therapy practices document administered doses, link diagnosis codes, and submit clean J2407 claims the first time.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The arithmetic on J2407 is the easy part. What sinks these claims is everything around the number, which is why the four checkpoints earn their place.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you bill oritavancin more than a few times a month, fix the source rather than the habit. Pull the administered dose straight from the infusion record instead of a transcription, and the unit error stops being possible.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The trade-off worth remembering is timing. Prior authorization and admission status can only be settled before the infusion. Once the drug is in, an appeal is the only route left, and it is a slow one.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau ties infusion records to J2407 claims.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Not sure what your clearinghouse actually sends to the payer?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/837-file\/\">What is an 837 file?<\/a> walks through the electronic claim format your J2407 line ends up inside.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need to read what the payer sent back?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/electronic-remittance-advice\/\">Electronic remittance advice<\/a> explains how to reconcile paid, adjusted, and denied lines against your claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Still waiting on payer approval to bill at all?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/how-to-get-credentialed-with-insurance-companies\/\">How to get credentialed with insurance companies<\/a> covers the paperwork and the timelines for each payer.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing other HCPCS items in the same visit?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-g0269\/\">HCPCS code G0269<\/a> shows how a procedure-based HCPCS code differs from a per-milligram drug code.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Worried an audit would find something?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/medical-billing-compliance\/\">Medical billing compliance<\/a> sets out the laws, the common violations, and a checklist you can work through.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786974397645\"><h3 class=\"schema-faq-question\">What is HCPCS code J2407?<\/h3> <p class=\"schema-faq-answer\">HCPCS code J2407 is the Level II billing code for injection of oritavancin, sold as Orbactiv, billed per 10 mg administered. It bills Medicare Part B and commercial payers for single-dose IV antibiotic therapy. The approved indication is acute bacterial skin and skin structure infections (ABSSSI) treated in outpatient settings.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974397646\"><h3 class=\"schema-faq-question\">How many units of J2407 are billed for a standard dose?<\/h3> <p class=\"schema-faq-answer\">The FDA-approved dose is a single 1,200 mg infusion, which bills as 120 units of J2407. The arithmetic is 1,200 divided by 10 mg per unit. The Orbactiv label carries no reduced-dose regimen, so if a prescriber orders a different amount, bill the milligrams actually administered.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974397651\"><h3 class=\"schema-faq-question\">Do you bill the infusion separately from J2407?<\/h3> <p class=\"schema-faq-answer\">Yes. J2407 pays for the drug only, and the infusion is a separate administration service. A 3-hour Orbactiv infusion is normally reported as CPT 96365 for the first hour, plus two units of 96366 for the additional hours. Leaving those codes off means the visit goes unpaid.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974397647\"><h3 class=\"schema-faq-question\">Does Medicare cover J2407?<\/h3> <p class=\"schema-faq-answer\">Yes. Medicare Part B covers J2407 when oritavancin is administered in an outpatient setting. That includes a physician office, an ambulatory infusion center, or a hospital outpatient department. The drug is reimbursed under the ASP plus 6% methodology. It is not separately billable under Part A for inpatient admissions.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974397648\"><h3 class=\"schema-faq-question\">What is the difference between J2406 and J2407?<\/h3> <p class=\"schema-faq-answer\">J2407 is assigned to Orbactiv and J2406 is assigned to Kimyrsa. Both products contain oritavancin, but each has its own NDC and its own HCPCS code. Billing the wrong code for the administered product is a compliance error. Match the code to the brand on the pharmacy label and infusion record.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974397649\"><h3 class=\"schema-faq-question\">What ICD-10 codes support J2407 billing?<\/h3> <p class=\"schema-faq-answer\">Medical necessity for J2407 is supported by ICD-10-CM codes for ABSSSI. That means cellulitis codes in the L03 range, cutaneous abscess codes in the L02 range, and MRSA-specific codes such as B95.62. The diagnosis code must match the clinical documentation, including the infection site and the pathogen.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974397650\"><h3 class=\"schema-faq-question\">Is prior authorization required for J2407?<\/h3> <p class=\"schema-faq-answer\">Traditional Medicare Part B does not universally require prior authorization for J2407, but most Medicare Advantage plans and commercial payers do. Requirements vary by plan and change annually. Confirm prior authorization status with the payer before scheduling the infusion, because post-service appeals on high-cost injectables are slow.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>J2407 covers oritavancin per 10 mg, so a 1,200 mg Orbactiv dose bills as 120 units. Here&rsquo;s what else the claim needs.<\/p>\n","protected":false},"author":83,"featured_media":183231,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"85","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1548,1115],"tags":[1439,1582,2953,1625,3044],"class_list":["post-183232","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-hcpcs","category-iv-therapy","tag-claims-management","tag-hcpcs","tag-j-code-billing","tag-j-codes","tag-medicare-part-b"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>HCPCS code J2407: 120 units and how to bill them<\/title>\n<meta name=\"description\" content=\"HCPCS code J2407 covers oritavancin per 10 mg, so a 1,200 mg Orbactiv dose bills as 120 units. Here&#039;s what else the claim needs.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j2407\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HCPCS code J2407: 120 units and how to bill them\" \/>\n<meta property=\"og:description\" content=\"HCPCS code J2407 covers oritavancin per 10 mg, so a 1,200 mg Orbactiv dose bills as 120 units. Here&#039;s what else the claim needs.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j2407\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-18T07:52:01+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-18T07:52:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/hcpcs-code-j2407.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Anja Dodevska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Anja Dodevska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"13 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/\"},\"author\":{\"name\":\"Anja Dodevska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\"},\"headline\":\"HCPCS code J2407: Oritavancin (Orbactiv) billing guide\",\"datePublished\":\"2026-08-18T07:52:01+00:00\",\"dateModified\":\"2026-08-18T07:52:04+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/\"},\"wordCount\":2512,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/hcpcs-code-j2407.webp\",\"keywords\":[\"claims management\",\"Hcpcs\",\"J Code Billing\",\"J Codes\",\"Medicare Part B\"],\"articleSection\":[\"Billing Codes\",\"HCPCS\",\"IV Therapy\"],\"inLanguage\":\"fr-FR\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/\",\"name\":\"HCPCS code J2407: 120 units and how to bill them\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/hcpcs-code-j2407.webp\",\"datePublished\":\"2026-08-18T07:52:01+00:00\",\"dateModified\":\"2026-08-18T07:52:04+00:00\",\"description\":\"HCPCS code J2407 covers oritavancin per 10 mg, so a 1,200 mg Orbactiv dose bills as 120 units. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\",\"name\":\"Anja Dodevska\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-CE0C072E-91B7-4BB7-BD27-D1E3B38ED0CA-scaled-1-96x96.jpg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-CE0C072E-91B7-4BB7-BD27-D1E3B38ED0CA-scaled-1-96x96.jpg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-CE0C072E-91B7-4BB7-BD27-D1E3B38ED0CA-scaled-1-96x96.jpg\",\"caption\":\"Anja Dodevska\"},\"description\":\"Anja Dodevska writes about healthcare, dermatology, and the day-to-day realities of running a medical practice for Pabau. She enjoys breaking down complex topics into clear, accessible content and has a soft spot for the often-overlooked aspects of clinic life. When she's not writing, she's exploring cafes, walking her dog, or spending time with friends and family.\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/blog\\\/author\\\/anja-dodevska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397645\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397645\",\"name\":\"What is HCPCS code J2407?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"HCPCS code J2407 is the Level II billing code for injection of oritavancin, sold as Orbactiv, billed per 10 mg administered. It bills Medicare Part B and commercial payers for single-dose IV antibiotic therapy. The approved indication is acute bacterial skin and skin structure infections (ABSSSI) treated in outpatient settings.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397646\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397646\",\"name\":\"How many units of J2407 are billed for a standard dose?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The FDA-approved dose is a single 1,200 mg infusion, which bills as 120 units of J2407. The arithmetic is 1,200 divided by 10 mg per unit. The Orbactiv label carries no reduced-dose regimen, so if a prescriber orders a different amount, bill the milligrams actually administered.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397651\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397651\",\"name\":\"Do you bill the infusion separately from J2407?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. J2407 pays for the drug only, and the infusion is a separate administration service. A 3-hour Orbactiv infusion is normally reported as CPT 96365 for the first hour, plus two units of 96366 for the additional hours. Leaving those codes off means the visit goes unpaid.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397647\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/hcpcs-code-j2407\\\/#faq-question-1786974397647\",\"name\":\"Does Medicare cover J2407?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Medicare Part B covers J2407 when oritavancin is administered in an outpatient setting. That includes a physician office, an ambulatory infusion center, or a hospital outpatient department. The drug is reimbursed under the ASP plus 6% methodology. 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The approved indication is acute bacterial skin and skin structure infections (ABSSSI) treated in outpatient settings.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j2407\/#faq-question-1786974397646","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j2407\/#faq-question-1786974397646","name":"How many units of J2407 are billed for a standard dose?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The FDA-approved dose is a single 1,200 mg infusion, which bills as 120 units of J2407. The arithmetic is 1,200 divided by 10 mg per unit. 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