Injection of vancomycin hydrochloride made by Xellia, billed per 10 mg

This code represents the administration of a specific formulation of vancomycin hydrochloride, manufactured by Xellia, which has been determined not to be therapeutically equivalent to other vancomycin products. Vancomycin is a glycopeptide antibiotic used to treat serious bacterial infections, particularly those caused by Gram-positive bacteria resistant to other antibiotics. This non-equivalence implies potential differences in efficacy or safety profiles compared to other vancomycin formulations.

Use this code when billing for the injection of vancomycin hydrochloride specifically manufactured by Xellia, as indicated by the drug's National Drug Code (NDC) or manufacturer information on the medication label. This code is appropriate when the provider's documentation clearly specifies the use of Xellia's vancomycin due to its distinct therapeutic profile. Documentation should support the medical necessity for this particular formulation.

• Verify the manufacturer of the vancomycin administered; this code is specific to Xellia's product.
• Do not use this code for generic vancomycin or vancomycin from other manufacturers, even if therapeutically equivalent.
• Ensure the dosage administered is accurately reflected, as this code represents the drug itself, not a specific dose.