How To Use HCPCS Code B4158

HCPCS code B4158 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 B4158?

HCPCS code B4158 is used to identify the enteral feeding supply kit for syringe feeding, per day. This code represents a complete and intact nutritional support system for patients who require enteral feeding. It includes all the necessary supplies for administering nutrition through a syringe, such as the feeding/flushing syringe, administration set tubing, dressings, and tape.

2. Official Description

The official description of HCPCS code B4158 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 ped complete intact nut.”

3. Procedure

1. Prepare the enteral feeding supply kit by gathering all the necessary components, including the feeding/flushing syringe, administration set tubing, dressings, and tape.
2. Ensure that the kit is intact and all supplies are sterile and in proper working condition.
3. Follow the healthcare provider’s instructions for preparing the enteral nutrition formula and connecting the administration set tubing to the syringe.
4. Administer the enteral nutrition to the patient by slowly pushing the plunger of the syringe to deliver the prescribed amount of nutrition.
5. Monitor the patient during the feeding process and make any necessary adjustments as directed by the healthcare provider.
6. After the feeding is complete, flush the enteral feeding tube with the provided flushing syringe to ensure proper tube patency.
7. Secure the enteral feeding tube with the dressings and tape included in the kit to prevent dislodgement or contamination.

4. When to use HCPCS code B4158

HCPCS code B4158 should be used when billing for the enteral feeding supply kit for syringe feeding, per day. This code is applicable when a complete and intact nutritional support system is provided to patients who require enteral feeding. It is important to ensure that all the supplies included in the kit are used and documented appropriately to support the use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4158, healthcare providers need to document the following:

• Date of service
• Number of days the enteral feeding supply kit was provided
• Details of the supplies included in the kit, such as the feeding/flushing syringe, administration set tubing, dressings, and tape
• Prescribed enteral nutrition formula
• Any additional instructions or modifications made to the enteral feeding process

It is important to ensure accurate and detailed documentation to support the medical necessity of the enteral feeding supply kit and facilitate proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code B4158 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 has been in use since its inception and continues to accurately represent the enteral feeding supply kit for syringe feeding, per day.

7. Medicare and Insurance Coverage

HCPCS code B4158 is eligible for coverage under Medicare and other insurance plans. The pricing indicator code 46 indicates that the carrier determines the pricing for this code. The multiple pricing indicator code A signifies that this code is not applicable as HCPCS priced under one methodology. Healthcare providers should refer to the specific guidelines and policies of Medicare and other insurance plans to determine the reimbursement rates and coverage criteria for HCPCS code B4158.

8. Examples

Here are five examples of when HCPCS code B4158 should be billed:

1. A patient with a medical condition that prevents them from consuming food orally requires enteral feeding using a syringe. The healthcare provider provides the patient with a complete enteral feeding supply kit, including the necessary syringe, administration set tubing, dressings, and tape, for a duration of 7 days.
2. An infant with a congenital anomaly affecting their ability to swallow requires enteral feeding through a syringe. The healthcare provider supplies the infant’s caregiver with an enteral feeding supply kit, which includes the required syringe, administration set tubing, dressings, and tape, for a period of 30 days.
3. A patient undergoing chemotherapy experiences difficulty in eating and requires enteral feeding using a syringe. The healthcare provider prescribes an enteral feeding supply kit, including the necessary syringe, administration set tubing, dressings, and tape, to be used for 14 days.
4. A patient with a gastrointestinal disorder requires enteral feeding through a syringe due to their inability to tolerate oral intake. The healthcare provider provides the patient with an enteral feeding supply kit, which includes the required syringe, administration set tubing, dressings, and tape, for a duration of 60 days.
5. An elderly patient with dysphagia requires enteral feeding using a syringe. The healthcare provider supplies the patient’s caregiver with an enteral feeding supply kit, including the necessary syringe, administration set tubing, dressings, and tape, for a period of 90 days.