Summary & Overview
HCPCS J0640: Injection, Leucovorin Calcium, 50 mg
HCPCS Level II code J0640 denotes a 50 mg unit of leucovorin calcium supplied for injection. Leucovorin is frequently administered as supportive care alongside certain chemotherapeutic agents to reduce toxicity or enhance efficacy, making this code relevant across oncology infusion settings nationwide. Billing and unitization of leucovorin influence episode-level drug costs and infusion service lines.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a compact overview of the code's clinical role, standard sites of service, and the payer mix that commonly reimburses for parenteral cytoprotective and adjunctive oncology medications.
This publication summarizes benchmarks and payment considerations, clarifies typical billing context for infusion centers and hospital outpatient departments, and outlines clinical context for use with chemotherapy regimens. It provides practical reference material for coding teams, revenue cycle staff, and clinicians who need a concise national perspective on how HCPCS Level II code J0640 is used and billed. Data not available in the input.
Billing Code Overview
HCPCS Level II code J0640 describes an injection of leucovorin calcium, per 50 mg. This code represents administration of leucovorin calcium, a medication commonly used as a cytoprotective agent and as a biochemical modulator in conjunction with certain chemotherapy regimens.
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Service type: Medication injection administration
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Typical site of service: Outpatient infusion center, hospital outpatient department, or clinic where parenteral chemotherapy support is provided
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient receiving intravenous folinic acid (leucovorin calcium) as part of a chemotherapy regimen to enhance efficacy or to rescue healthy cells after high-dose methotrexate. The patient arrives to an outpatient infusion center or hospital oncology infusion suite with an order for leucovorin calcium, J0640, dosed per 50 mg vial. The workflow: the oncology physician or advanced practice provider documents the indication, dose, route (intravenous), and timing in the electronic health record; the pharmacy compounds the appropriate number of 50 mg vials to achieve the prescribed total dose; a registered nurse verifies patient identity, reviews allergies, obtains vital signs, and administers the IV bolus or short infusion per protocol; the nurse documents lot numbers and vial counts, records administration time and any patient response, and the billing team submits J0640 with applicable modifiers for the infused quantity and site of service. Typical sites of service include outpatient hospital infusion centers, physician office-based infusion suites, and inpatient hospital settings when used for rescue after high-dose methotrexate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 |