Question:
Can you tell me more about what happens when drugs are mapped to revenue code 636?
Answer:
Drugs and biologicals that are mapped to revenue code 636 will appear on the claim on individual line items for detail reporting of the HCPCS code, unit of measure (the multiple of the code description to represent the billed amount of drug), and the charge for the drug. If a commercial contract specifies the use of revenue code 636 only for high-cost or “carve out” drugs, the facility must use the revenue code as stipulated.
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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