How To Use HCPCS Code B4035

HCPCS code B4035 describes the enteral feeding supply kit for syringe feeding, per day. This code is used to identify the specific supplies and equipment needed for enteral feeding through a syringe. It includes items such as feeding and flushing syringes, administration set tubing, dressings, and tape. The code was added to the Healthcare Common Procedure Coding System on January 01, 1986, and its action effective date is January 01, 2011. It falls under the special coverage instructions category (HCPCS Coverage Code D) and does not require any maintenance (HCPCS Action Code N).

1. What is HCPCS B4035?

HCPCS code B4035 is used to identify the enteral feeding supply kit for syringe feeding, per day. It is important to note that this code specifically refers to the supplies and equipment required for enteral feeding using a syringe. The code does not cover other methods of enteral feeding, such as through a pump or gravity feeding.

2. Official Description

The official description of HCPCS code B4035 is “Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape.” The short description for this code is “Enteral feed supp pump per d.”

3. Procedure

1. Prepare the enteral feeding supply kit, ensuring that it includes a feeding/flushing syringe, administration set tubing, dressings, and tape.
2. Verify the patient’s enteral feeding prescription and ensure that syringe feeding is the appropriate method.
3. Cleanse the hands and wear appropriate personal protective equipment.
4. Connect the administration set tubing to the feeding/flushing syringe.
5. Prime the administration set tubing to remove any air bubbles.
6. Prepare the enteral formula according to the patient’s prescribed instructions.
7. Fill the feeding/flushing syringe with the prepared enteral formula.
8. Connect the feeding/flushing syringe to the patient’s enteral access device.
9. Administer the enteral formula slowly and steadily, following the prescribed rate.
10. Monitor the patient during the enteral feeding process for any adverse reactions or complications.
11. Flush the enteral access device with the appropriate amount of water or prescribed flush solution after completing the feeding.
12. Secure the enteral access device with dressings and tape to prevent dislodgement.

4. When to use HCPCS code B4035

HCPCS code B4035 should be used when providing enteral feeding through a syringe. This code is applicable when the patient’s enteral feeding prescription specifies syringe feeding as the method of administration. It is important to ensure that the supplies and equipment included in the enteral feeding supply kit match the items listed in the code description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4035, healthcare providers should ensure that the following documentation is included:

• Prescription or order for enteral feeding specifying syringe feeding
• Documentation of the patient’s enteral feeding needs and any relevant medical conditions
• Documentation of the supplies and equipment provided, including the feeding/flushing syringe, administration set tubing, dressings, and tape
• Date and duration of the enteral feeding

6. Historical Information and Code Maintenance

HCPCS code B4035 was added to the Healthcare Common Procedure Coding System on January 01, 1986. It has an action effective date of January 01, 2011, indicating that no maintenance actions have been taken for this code. The code falls under the pricing indicator code 39, which represents parenteral and enteral nutrition. It is not priced under multiple methodologies (pricing indicator code A).

7. Medicare and Insurance Coverage

HCPCS code B4035 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 39 indicates that it is associated with parenteral and enteral nutrition, which is typically covered by insurance. However, it is important to verify coverage with the specific insurance provider and follow their billing guidelines.

8. Examples

Here are some examples of scenarios where HCPCS code B4035 would be billed:

1. A patient with a prescription for enteral feeding through a syringe receives the necessary supplies and equipment for a one-day supply.
2. A home healthcare provider administers enteral feeding through a syringe to a patient and provides the associated supplies and equipment for a three-day supply.
3. A hospital provides enteral feeding through a syringe to a patient during their inpatient stay and includes the required supplies and equipment in the billing.
4. A skilled nursing facility administers enteral feeding through a syringe to a resident and bills for the enteral feeding supply kit.
5. An outpatient clinic provides enteral feeding through a syringe to a patient and bills for the supplies and equipment used during the procedure.