Revenue Code 636 Definition

Nov 2 2018 as defined by the medicare administrative contractors.

Revenue code 636 definition. The total number of units as a multiple of 1mcg is placed in the unit field. Reimbursement is based on the payment allowance limit for medicare part b drugs as found in the asp pricing file. In the hospital inpatient setting payment under part b is made on bill type 12x when billed with revenue code 0636. Revised january 1 2016.

Drugs reported under revenue code 636 are included in this calculation. Reimbursement guide executive summary sample billing. Cms has recommended that facility providers report all drugs with a hcpcs code under revenue code 636 to better capture actual pharmacy overhead cost through claims data. Billing procedures regarding national drug code ndc medicaidprovider mt gov.

Hcpcs codes need not be reimbursed separately to be reported under revenue code 636. Charge revenue code 636 along with one of the following hcpcs codes as how 3m eapgs work colorado gov. Claims with ed or observation revenue codes present. Inj heparin sodium per.

Quick coding view for medicare medicaid and. Inpatient services has been amended to include all outpatient services. Mar 7 2008 submission of national drug codes ndcs on claims submitted with certain. Jun 1 2018 december 2019.

The non covered services defined in a member s contract may include but are not limited to the following. Revenue code 0636 definition. 636 pharmacy 025x extension drugs requiring detailed coding 650 hospice 651 hospice routine home care 652 hospice continuous home care 656 hospice general inpatient care non respite. Administration unit by revenue code 250 or 636 with one of the following j codes.

Facilities report separately payable hcpcs codes under revenue code 636 drugs with detailed coding to ensure that they receive reimbursement. Cms manual system cms gov. Effective january 1 2019 for new renal dialysis drugs and biologicals that are eligible for an revenue code 0636 on the esrd type of bill tob. Revenue code list cpt hcpcs for providers effective march 15 2020.

Pharmaceuticals billed with revenue center code rcc 025x and or 0636 with a. For inpatient services the revenue code identifies the department in which the service was given the types of services provided and the supplies used. Weight 01 full payment.