How To Use HCPCS Code B4157

HCPCS code B4157 describes an enteral feeding supply kit that is used for syringe feeding. This code includes various components 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 in order to accurately bill for the services provided.

1. What is HCPCS B4157?

HCPCS code B4157 is used to identify an enteral feeding supply kit that is specifically designed for syringe feeding. This kit includes all the necessary components for administering enteral nutrition through a syringe. It is important to note that this code is only applicable for syringe feeding and not for other methods of enteral nutrition delivery.

2. Official Description

The official description of HCPCS code B4157 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 “Ef special metabolic inherit.”

3. Procedure

1. Prepare the enteral feeding supply kit by ensuring that all the necessary components are present.
2. Verify the patient’s enteral feeding prescription and ensure that syringe feeding is the appropriate method of nutrition delivery.
3. Cleanse the hands and wear appropriate personal protective equipment.
4. Assemble the feeding syringe by attaching the administration set tubing to the syringe.
5. Connect the other end of the administration set tubing to the enteral feeding tube.
6. Administer the prescribed amount of enteral nutrition through the syringe, following the recommended feeding schedule.
7. Flush the enteral feeding tube with the appropriate amount of water or saline solution after each feeding.
8. Secure the enteral feeding tube with dressings and tape to prevent dislodgement.
9. Document the enteral feeding procedure in the patient’s medical record.

4. When to use HCPCS code B4157

HCPCS code B4157 should be used when providing enteral nutrition through syringe feeding. This code is specifically for patients who require enteral nutrition due to special metabolic inherit conditions. It is important to ensure that the patient meets the eligibility criteria for using this code, as specified by the payer or insurance guidelines.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4157, healthcare providers need to document the following information:

• Date of service
• Number of days the enteral feeding supply kit was provided
• Prescribed amount of enteral nutrition
• Documentation supporting the medical necessity of enteral nutrition
• Any additional supplies or services provided in conjunction with the enteral feeding

Providers should also ensure that they are following the specific billing guidelines set forth by the payer or insurance company to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code B4157 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. This code falls under the pricing indicator code 39, which represents parenteral and enteral nutrition. It is not applicable for multiple pricing methodologies.

7. Medicare and Insurance Coverage

HCPCS code B4157 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 39 indicates that this code is used for parenteral and enteral nutrition, which is typically covered by insurance. However, it is important to verify coverage with the specific payer or insurance company to ensure reimbursement.

8. Examples

Here are five examples of when HCPCS code B4157 should be billed:

1. A patient with a special metabolic inherit condition requires enteral nutrition through syringe feeding for a period of 7 days.
2. A healthcare provider administers enteral nutrition through syringe feeding to a patient with a documented need for special metabolic inherit support.
3. An enteral feeding supply kit, including syringe, administration set tubing, dressings, and tape, is provided to a patient for syringe feeding over a period of 30 days.
4. A patient with a special metabolic inherit condition receives enteral nutrition through syringe feeding during a hospital stay.
5. An enteral feeding supply kit is provided to a patient for syringe feeding at home, following a physician’s prescription for special metabolic inherit support.