How To Use HCPCS Code B4036

HCPCS code B4036 describes the enteral feeding supply kit for syringe feeding, per day. This code is used to identify the specific supplies included in the kit, such as feeding/flushing syringe, administration set tubing, dressings, and tape. It is important for medical coders to understand the meaning and usage of this code to ensure accurate billing and reimbursement.

1. What is HCPCS B4036?

HCPCS code B4036 is used to identify the enteral feeding supply kit for syringe feeding, per day. It is specifically designed for patients who require enteral feeding through syringe administration. The kit includes various supplies necessary for the enteral feeding process, such as feeding/flushing syringe, administration set tubing, dressings, and tape.

2. Official Description

The official description of HCPCS code B4036 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 sup kit grav by.”

3. Procedure

1. Prepare the enteral feeding supply kit by ensuring all necessary supplies are included.
2. Verify the patient’s enteral feeding requirements and ensure the syringe administration method is appropriate.
3. Administer the enteral feeding using the supplies included in the kit.
4. Monitor the patient during the feeding process for any complications or adverse reactions.
5. Document the enteral feeding procedure in the patient’s medical record.

4. When to use HCPCS code B4036

HCPCS code B4036 should be used when billing for the enteral feeding supply kit specifically designed for syringe feeding, per day. It is important to ensure that the patient meets the eligibility criteria for enteral feeding and that the syringe administration method is appropriate for their condition.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4036, healthcare providers need to document the medical necessity for enteral feeding and the specific supplies provided in the kit. The documentation should include the patient’s enteral feeding requirements, the administration method used, and any complications or adverse reactions observed during the feeding process.

6. Historical Information and Code Maintenance

HCPCS code B4036 was added to the Healthcare Common Procedure Coding System on January 01, 1986. It has an effective date of January 01, 2011. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code B4036 is covered by Medicare and other insurance providers. The pricing indicator code 39 indicates that it falls under the category of parenteral and enteral nutrition. The multiple pricing indicator code A means that it is not applicable as HCPCS priced under one methodology. Healthcare providers should follow the specific billing guidelines and reimbursement policies of Medicare and other insurance carriers when submitting claims for this code.

8. Examples

Here are five examples of when HCPCS code B4036 should be billed:

1. A patient with a medical condition that requires enteral feeding through syringe administration receives the enteral feeding supply kit for one day.
2. A healthcare facility provides the enteral feeding supply kit to a patient who is unable to consume food orally due to a medical condition.
3. A home healthcare provider supplies the enteral feeding kit to a patient who requires enteral nutrition support at home.
4. A patient undergoing a medical procedure that temporarily restricts oral intake receives the enteral feeding supply kit for the duration of the procedure.
5. A patient with a chronic illness that affects their ability to consume food orally receives the enteral feeding supply kit on a daily basis.