Asked by: Bouazza Marote
business and finance healthcare industry

What is Procedure Code 636?

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Facilities report separately payable HCPCS codes under revenue code 636 (drugs with detailed coding) to ensure that they receive reimbursement. CMS uses HCPCS-coded drugs to establish the percentage of payment added to the average sales price to cover pharmacy overhead and expenses.


Also to know is, can you bill Revenue Code 636 on an inpatient claim?

Revenue Code 636 is used. It requires HCPCS. Other inpatient drugs continue to be billed without HCPCS codes under pharmacy. Coverage is not applicable to inpatient Part B claims.

Subsequently, question is, what is the CPT code for administration of injections? 96372

Beside above, what is the difference between Revenue Code 250 and 636?

What is the difference and should we use revenue code 636 to report all drugs with HCPCS codes? A: Many facilities report packaged drugs under revenue code 250 regardless of whether an applicable HCPCS code exists. Drugs reported under revenue code 636 are included in this calculation.

Does rev code 250 require NDC?

Accordingly, general pharmacies (e.g. revenue code 250) do not require NDC code to be billed on the corresponding revenue service line.

Related Question Answers

Yisenia Follmar

Professional

What is Revenue Code 301?

Medical/surgical supplies and devices- other. 300. Laboratory. 301.

Juliann Wepierre

Professional

Who uses revenue codes?

Revenue codes are 3-digit numbers that are used on hospital bills to tell the insurance companies either where the patient was when they received treatment, or what type of item a patient might have received as a patient. A medical claim will not be paid if this is missing from a bill.

Malamine Saraf

Professional

Does Revenue Code 270 require Hcpcs?

Only the revenue codes listed below are recognized on the outpatient hospital claim as facility revenue codes. Do not list both a facility code and a CPT/HCPCS code. * Revenue code 270 should be reported only once on the outpatient claim. It is to be reported for medical or surgical supplies or both combined.

Anta Abrahimoff

Explainer

Does Revenue Code 637 require Hcpcs code?

NOTE: Do not utilize revenue code 637 (self-administrable drugs not requiring detailed coding) for the reporting of those self-administered drugs and biologicals that are statutorily covered.

Jiaxin Volcik

Explainer

What revenue codes require NDC number?

Institutional providers
All claims for outpatient services containing the following pharmacy revenue codes and an unlisted and/or non-specific (CPT or HCPCS) code will require a valid NDC when submitted: 250-259, 262, 263, 331, 332, 335, 343, 344, and 631-637.

Staci Ligorner

Explainer

Does Revenue Code 762 require Hcpcs?

Observation services are billed under revenue code 762, with the appropriate CPT/HCPCS code (99217-99220 and 99234-99236.) Emergency department visit or clinic visit or critical care visit is required the day before or the day of observation.

Neriman Hattensauer

Pundit

What is the Rev Code 278?

Revenue codes are three-digit codes that affect reimbursement and represent the services provided by the ASC facility for a payer. Implants are listed with the 278 revenue code or with 276 for intraocular lenses (IOL) (used in cataract procedures).

Chihab Cadete

Pundit

How do I bill for Prolia injection?

PROCEDURE CODE (BOX 24D)
Use CPT code representing procedure performed, such as 96372, therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular; or 96401, chemotherapy administration, subcutaneous or intramuscular; non-hormonal antineoplastic.

Zenaide Duma

Pundit

What is the revenue code for pharmacy?

Revenue Code Description
Pharmacy
250 General classification
251 Generic drugs
252 Nongeneric drugs

Annita Fisico

Pundit

How do you bill a b12 shot?

Vitamin B-12 injections should be billed using the following HCPCS code: J3420 - Injection, vitamin B-12 Cyanocobalamin, up to 1000 mcg.

Krzysztof Ecca

Pundit

What does CPT code 96372 mean?

CPT Code 96372 - Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration) - AAPC Coder.

Kostadin Calomeu

Teacher

Can you Bill 96372 twice?

Yes, it is till applicable if the drug is prepared and drawn up into two separate syringes and it is then administered in two individual injections in two distinct anatomic sites, you can bill two units of code 96372 (billing second unit with modifier 76).

Frankie Preugszat

Supporter

How do I get an NDC code?

Assignment of NDC number to non-drug products is extremely prohibited. Each listed drug product is assigned a unique 10-digit, 3-segment number. This number, known as the NDC, identifies the labeler, product, and trade package size. The first segment, the labeler code, is assigned by the FDA.

Dancho Adashevsky

Supporter

Where can I find NDC codes?

The FDA maintains a searchable database of NDC codes on their website. NDC numbers can also be found in the drug product labeling (the package insert) as well as on the package itself. Learn More: Use the Drugs.com Pill Identification Wizard to identify medications by NDC number.

Georgica Zion

Supporter

How do you calculate NDC units?

HCPCS billing units are calculated by dividing the amount administered by the units found in the procedure code description. The calculated HCPCS billing unit is also needed to determine the correct NDC billing unit. NDC billing units are calculated by multiplying the HCPCS billing unit by the conversion factor.

Marca Furrier

Beginner

What is an NDC code for claims?

“NDC” stands for National Drug Code. It is a unique, 3-segment numeric identifier assigned to each medication listed under Section 510 of the U.S. Federal Food, Drug and Cosmetic Act. The first segment of the NDC identifies the labeler (i.e., the company that manufactures or distributes the drug).

Maisa Andryukov

Beginner

What are Q codes in medical billing?

The Q codes are used to identify services that would not be given a CPT code, such as drugs, biologicals, and other types of medical equipment or services, and which are not identified by national Level II codes. However, these services and equipment need codes for claims processing purposes.

Dimitri Belman

Beginner

What does n4 mean in NDC?

Example: In this example, the 'N4' is used as the Product ID Qualifier with an NDC code of '12345678901'. Code 'UN' is used to identify the unit quantity of 30 reported as '000030000' (Nine-digit quantity). Box 44 – Using the HCPCS/RATE/HIPPS Code field, enter the five-character HCPCS code.

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EveryThingWhat Staff Editor

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1st July, 2021

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