How To Use HCPCS Code B4160

HCPCS code B4160 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 B4160?

HCPCS code B4160 is used to identify the enteral feeding supply kit for syringe feeding, per day. This code specifically refers to the supplies included in the kit, which are necessary for administering enteral nutrition to patients. The supplies may vary but commonly include a feeding/flushing syringe, administration set tubing, dressings, and tape.

2. Official Description

The official description of HCPCS code B4160 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 caloric dense>/=0.7kc.”

3. Procedure

1. Ensure that the patient is eligible for enteral feeding and has a prescription for the specific caloric dense formula.
2. Gather all the necessary supplies included in the enteral feeding supply kit, such as a feeding/flushing syringe, administration set tubing, dressings, and tape.
3. Prepare the enteral feeding formula according to the prescribed instructions.
4. Connect the administration set tubing to the feeding/flushing syringe and prime the tubing to remove any air bubbles.
5. Cleanse the patient’s feeding tube site with an appropriate antiseptic solution.
6. Secure the administration set tubing to the patient’s feeding tube using the provided dressings and tape.
7. Administer the enteral feeding formula through the syringe, following the prescribed rate and duration.
8. Flush the feeding tube with an appropriate amount of water or saline solution after the feeding is complete.
9. Document the enteral feeding procedure in the patient’s medical record, including the date, time, formula used, rate of administration, and any complications or observations.

4. When to use HCPCS code B4160

HCPCS code B4160 should be used when billing for the enteral feeding supply kit for syringe feeding, per day. This code is applicable when providing enteral nutrition to patients who require a caloric dense formula with a minimum of 0.7 kilocalories per milliliter. It is important to ensure that the patient meets the eligibility criteria for enteral feeding and that the supplies included in the kit are necessary for their specific needs.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4160, healthcare providers need to document the medical necessity of enteral feeding, including the patient’s diagnosis, the prescribed caloric dense formula, and the duration of enteral feeding. Additionally, providers should include detailed documentation of the supplies used from the enteral feeding supply kit, such as the feeding/flushing syringe, administration set tubing, dressings, and tape. It is important to maintain accurate and complete documentation to support the medical necessity of the service and ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code B4160 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 for enteral feeding supply kits for syringe feeding since its inception.

7. Medicare and Insurance Coverage

HCPCS code B4160 is covered by Medicare and other insurance providers. 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. Providers should follow the specific guidelines and reimbursement policies of Medicare and other insurance carriers when billing for enteral feeding supply kits using HCPCS code B4160.

8. Examples

Here are five examples of when HCPCS code B4160 should be billed:

1. A pediatric patient with a diagnosis of malnutrition requires enteral feeding using a caloric dense formula. The enteral feeding supply kit, including the feeding/flushing syringe, administration set tubing, dressings, and tape, is provided for one day.
2. A geriatric patient with dysphagia needs enteral feeding with a caloric dense formula. The enteral feeding supply kit, including the necessary supplies, is provided for three days.
3. A patient with a gastrointestinal disorder requires long-term enteral feeding using a specific caloric dense formula. The enteral feeding supply kit, including the supplies, is provided for one week.
4. A patient undergoing chemotherapy experiences difficulty with oral intake and requires enteral feeding using a caloric dense formula. The enteral feeding supply kit, including the necessary supplies, is provided for two weeks.
5. A patient with a severe burn injury needs enteral feeding with a specialized caloric dense formula. The enteral feeding supply kit, including the feeding/flushing syringe, administration set tubing, dressings, and tape, is provided for one month.