HCPCS Code Section: HCPCS B Codes

B4172

Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) – home mix Short Description: Parenteral sol amino acid 5. Coverage Code: Special coverage instructions apply …

B4104

Additive for enteral formula (e.g., fiber) Short Description: Additive for enteral formula Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

B4168

Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) – home mix Short Description: Parenteral sol amino acid 3. Coverage Code: Special coverage instructions apply Action Code: …

B4103

Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit Short Description: Ef ped fluid and electrolyte Coverage Code: Special coverage …

B4164

Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) – home mix Short Description: Parenteral 50% dextrose solu Coverage Code: Special coverage instructions apply Action …

B4162

Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 …

B4161

Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 …

B4160

Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered …

B4159

Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, …

B4158

Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories …