J0696HCPCS Level II

Injection, ceftriaxone sodium, per 250 mg

Antibiotic / Cephalosporin
The answer

J0696 is injection, ceftriaxone sodium, per 250 mg, billed at 250 mg = 1 Unit. It covers Rocephin (Ceftriaxone).

Code detail

Code
J0696
Code set
HCPCS Level II, maintained by CMS
Descriptor
Injection, ceftriaxone sodium, per 250 mg
Billable unit
250 mg = 1 Unit
Category
Antibiotic / Cephalosporin

Dose to units calculation

The quantity reported on the claim is the dose divided by the code’s billable unit.

Interactive Unit Multiplier Calculator

J0696

Calculate the exact number of billable HCPCS units to report on CMS-1500 / 837P claims based on the patient dose and single-dose vial waste.

MG
Units to report on claim:
1 Units
Based on 250 mg = 1 billable unit (0.4 exact)
Box 24 / HCPCS Quantity Formatted Line:J0696 UN1

Common Worked Examples:

Worked unit conversions for J0696
Dose administeredBillable unitUnits to report
50 mg250 mg = 1 Unit0.2
100 mg250 mg = 1 Unit0.4
200 mg250 mg = 1 Unit0.8
400 mg250 mg = 1 Unit1.6
1000 mg250 mg = 1 Unit4

Rounding and partial-unit rules vary by payer. Where a dose does not divide evenly, most payers expect the units actually administered plus a separate JW modifier line for the discarded remainder.

Drugs billed under J0696

1 brand name and 1 generic map to this code.

Generic

Ceftriaxone

Injection, ceftriaxone sodium, per 250 mg

Billing detail
Brand

Rocephin

Injection, ceftriaxone sodium, per 250 mg

Billing detail

Next steps

Find the NDCs for Ceftriaxone

FDA drug records with packaging, strengths and the 11-digit HIPAA conversion already applied.

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Convert the NDC for the claim

The three leading-zero rules that turn an FDA 10-digit code into the 11-digit form this claim line needs.

Open the guide

Terms used on this page

Billable unitThe quantity denominator built into a HCPCS drug code, which converts an administered dose into the number reported on the claim.Definition J-codeA HCPCS Level II code beginning with J that identifies a drug administered by a clinician rather than self-administered.Definition NDC quantityThe amount of drug actually taken from the package, expressed in the unit named by the unit qualifier.Definition JW modifierReports the amount of a single-dose container that was discarded rather than administered.Definition

HCPCS Level II is updated quarterly by CMS. Verify J0696 against the current release before submitting a high-value claim.