How To Use HCPCS Code B4104

HCPCS code B4104 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 accurately bill for the enteral feeding supplies provided.

1. What is HCPCS B4104?

HCPCS code B4104 is used to identify the enteral feeding supply kit for syringe feeding, per day. This code is specifically used for enteral feeding supplies that are administered through a syringe. It includes various components such as feeding/flushing syringe, administration set tubing, dressings, and tape. The code B4104 is essential for medical coders to accurately document and bill for the enteral feeding supplies provided to patients.

2. Official Description

The official description of HCPCS code B4104 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 of this code is “Additive for enteral formula.” It is important to use the exact descriptions provided to ensure accurate coding and billing.

3. Procedure

1. Prepare the enteral feeding supply kit, ensuring that it includes the necessary components such as feeding/flushing syringe, administration set tubing, dressings, and tape.
2. Administer the enteral formula through a syringe, following the prescribed instructions.
3. Monitor the patient during the feeding process to ensure proper administration and any potential complications.
4. Document the details of the enteral feeding procedure, including the date, time, and any relevant observations.

4. When to use HCPCS code B4104

HCPCS code B4104 should be used when providing enteral feeding supplies that are administered through a syringe. This code is specifically for syringe-fed enteral feeding kits and should not be used for other types of enteral feeding methods. It is important to review the patient’s medical records and the specific instructions provided by the healthcare provider to determine the appropriate use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4104, healthcare providers need to document the specific enteral feeding supplies provided, including the feeding/flushing syringe, administration set tubing, dressings, and tape. The documentation should also include the date of service and any relevant information regarding the patient’s condition or medical necessity for the enteral feeding supplies. It is important to follow the billing guidelines set by the payer to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code B4104 was added to the Healthcare Common Procedure Coding System on January 01, 2005. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important for medical coders to stay updated with any changes or revisions to the code to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

HCPCS code B4104 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established. It is important to review the specific coverage policies of Medicare and other insurance providers to determine the reimbursement for enteral feeding supplies.

8. Examples

Here are five examples of when HCPCS code B4104 should be billed:

1. A patient with a medical condition requiring enteral feeding receives a syringe-fed enteral feeding supply kit, including the necessary components.
2. A healthcare provider administers enteral feeding through a syringe to a patient with swallowing difficulties.
3. A patient undergoing a medical procedure that temporarily restricts oral intake receives enteral feeding supplies through a syringe.
4. A patient with a chronic illness requiring long-term enteral feeding receives daily supplies for syringe feeding.
5. A healthcare facility provides enteral feeding supplies to a patient being discharged for home care, including the necessary components for syringe feeding.