How To Use HCPCS Code B4161

HCPCS code B4161 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 these supplies.

1. What is HCPCS B4161?

HCPCS code B4161 is used to identify the enteral feeding supply kit for syringe feeding, per day. This code specifically includes but is not limited to feeding/flushing syringe, administration set tubing, dressings, and tape. It is important to note that this code is specific to enteral feeding supplies and should not be used for other types of feeding methods.

2. Official Description

The official description for HCPCS code B4161 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 hydrolyzed/amino acid.”

3. Procedure

1. Ensure that the patient requires enteral feeding via syringe.
2. Gather the necessary supplies for the enteral feeding supply kit, including a feeding/flushing syringe, administration set tubing, dressings, and tape.
3. Prepare the enteral feeding formula according to the patient’s specific needs.
4. Connect the administration set tubing to the feeding/flushing syringe.
5. Administer the enteral feeding formula to the patient using the syringe.
6. Monitor the patient during the feeding process for any adverse reactions or complications.
7. Document the administration of enteral feeding supplies and any relevant patient information.

4. When to use HCPCS code B4161

HCPCS code B4161 should be used when providing enteral feeding supplies via syringe to a patient. This code is specifically for patients who require enteral feeding and is not applicable for other types of feeding methods. It is important to ensure that the patient meets the criteria for enteral feeding and that the supplies included in the kit are necessary for their care.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4161, healthcare providers should ensure that the following documentation is included:

• Documentation supporting the medical necessity of enteral feeding supplies
• Documentation of the specific supplies provided, including the feeding/flushing syringe, administration set tubing, dressings, and tape
• Documentation of the quantity of supplies provided per day
• Any additional documentation required by the payer or insurance company

6. Historical Information and Code Maintenance

HCPCS code B4161 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 via syringe feeding since its inception.

7. Medicare and Insurance Coverage

HCPCS code B4161 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 46 indicates that the carrier determines the pricing for this code. This means that the reimbursement amount may vary depending on the carrier’s discretion and individual determination. It is important for healthcare providers to verify coverage and reimbursement policies with the specific payer or insurance company.

8. Examples

Here are five examples of when HCPCS code B4161 should be billed:

1. A patient with a medical condition requiring enteral feeding via syringe receives a supply kit including a feeding/flushing syringe, administration set tubing, dressings, and tape.
2. A pediatric patient with a specific dietary requirement receives a daily enteral feeding supply kit for hydrolyzed/amino acid formula.
3. A patient undergoing a surgical procedure requires enteral feeding via syringe during the recovery period.
4. A patient with a chronic illness requires long-term enteral feeding and receives a daily supply kit for syringe feeding.
5. A patient with a temporary inability to swallow due to a medical condition receives enteral feeding supplies via syringe until they are able to resume oral intake.