2025 HCPCS code S0040
Effective Date: N/A Temporary National Codes (Non-Medicare) - Non-Medicare Drug Codes Feed
Supply of 3.1 grams of injectable ticarcillin disodium and clavulanate potassium.
Medical necessity for S0040 must be supported by documentation demonstrating that the patient has a bacterial infection resistant to standard penicillin-like antibiotics, and that ticarcillin disodium and clavulanate potassium is the medically appropriate treatment. This may include microbiology reports, clinical findings, and prior treatment history.
The clinical responsibility for administering and monitoring treatment with ticarcillin disodium and clavulanate potassium typically falls upon the prescribing physician. This includes assessing the patient's condition, determining the appropriate dosage and duration of therapy, monitoring for adverse reactions, and adjusting treatment as needed.
In simple words: This code covers a 3.1-gram injection of two antibiotics, ticarcillin and clavulanate, used together to fight serious bacterial infections that are resistant to common penicillin-like antibiotics.
This code represents the supply of 3.1 grams of injectable ticarcillin disodium and clavulanate potassium. Ticarcillin disodium and clavulanate potassium are two types of antibiotics that, when combined, are effective against bacteria resistant to penicillin-type antibiotics. This combination treats infections such as septicemia (blood infection), lower respiratory tract infections, urinary tract infections, bone and joint infections, stomach infections, skin infections, and others.
Example 1: A patient presents with a severe lower respiratory tract infection resistant to standard antibiotic treatment. S0040 is used to bill for the administration of ticarcillin disodium and clavulanate potassium., A patient with a compromised immune system develops a complicated urinary tract infection. The physician prescribes ticarcillin disodium and clavulanate potassium, and S0040 is used for billing the medication supply., A post-surgical patient develops a deep wound infection. To combat the infection effectively, the physician orders ticarcillin disodium and clavulanate potassium, billing the provision using S0040.
Documentation should include the diagnosis necessitating the use of ticarcillin disodium and clavulanate potassium, the dosage administered, the route of administration, and any observed patient reactions.
** This is a non-Medicare code and should not be billed to Medicare. Coverage policies may vary among different payers.
- Payment Status: Non-Medicare
- Specialties:Infectious Disease, Internal Medicine, Surgery, Critical Care
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Independent Clinic, Federally Qualified Health Center