4042F Doc antibio not given
Also known as: antibiotic not given, prophylaxis withheld
Performance measure indicating documentation that appropriate antibiotics were not given when contraindicated. Records absence of unnecessary prophylaxis.
In Plain Language
appropriately not giving antibiotics
Clinical Context
Quality measure for appropriate antibiotic stewardship. Documents cases where prophylaxis is correctly omitted (e.g., very low-risk procedures or allergies).
RVU Information
CPT 4042F does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
Documentation should include the clinical indication, service details, and any applicable performance metrics. Coverage may vary by payer — verify acceptance before billing.
Specialties
Frequently Asked Questions
What is CPT code 4042F?
CPT 4042F (Doc antibio not given) is a Other code. Performance measure indicating documentation that appropriate antibiotics were not given when contraindicated. Records absence of unnecessary prophylaxis.
Who uses CPT code 4042F?
CPT 4042F is used by Surgery, Infection Control, All Specialties. Quality measure for appropriate antibiotic stewardship. Documents cases where prophylaxis is correctly omitted (e.g., very low-risk procedures or allergies).
When is CPT 4042F used?
Quality measure for appropriate antibiotic stewardship. Documents cases where prophylaxis is correctly omitted (e.g., very low-risk procedures or allergies).
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.