Revenue code 0636
Drugs requiring detailed coding
The revenue code for drugs that carry their own HCPCS code, which in practice means the expensive ones: infused biologics, chemotherapy, contrast agents, certain injectables. Each line should show the drug's J-code and the number of units.
Where this line goes wrong
Units are the trap
J-codes are billed in small dose units (for example per 10 mg). A drug given once can legitimately show 50 units, but a wrong unit count multiplies a large charge. Check the dose given against the units billed.
Wastage
Hospitals may bill the unused part of a single-use vial with a modifier (JW). It is allowed, but the wasted amount should be documented and should not exceed the vial size.
Want to know if this line is right on your own bill? Upload it to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute.
Check my bill for freeCheck it, then ask
- 1
Ask for the medication administration record and compare the dose given with the units billed for each J-code.
- 2
Look for JW (wastage) lines and check the documented waste.
- 3
Compare the charge per unit with the Medicare average sales price for the same J-code if you want a reference point.
The full walkthrough for this kind of bill: Your bill came in above the estimate.
Upload the bill to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute. If you want a specialist to dispute it for you, it is a flat $129, refunded in full if the bill isn't lowered by at least $129.
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People also ask
Why is contrast dye a separate charge?
Contrast for a CT or MRI is billed under 0636 with its own code, in addition to the scan. It is legitimate; check the units against the amount actually given.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.