How To Use HCPCS Code B4164

HCPCS code B4164 describes the enteral feeding supply kit for syringe feeding, per day. This code includes various components such as feeding/flushing syringe, administration set tubing, dressings, and tape. It falls under the coverage code D, which indicates that special coverage instructions apply. The code has no maintenance and was added to the HCPCS system on January 01, 1986. It is priced under the parenteral and enteral nutrition category with a pricing indicator code of 39. The code is applicable for enteral/parenteral nutrients/supplies services and does not have any anesthesia base unit quantity.

1. What is HCPCS B4164?

HCPCS code B4164 is used to identify the enteral feeding supply kit for syringe feeding, per day. It is specifically designed for patients who require enteral feeding through syringe administration. The kit includes essential components such as feeding/flushing syringe, administration set tubing, dressings, and tape. This code is essential for accurate billing and reimbursement purposes.

2. Official Description

The official description of HCPCS code B4164 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 “Parenteral 50% dextrose solu.”

3. Procedure

1. Prepare the enteral feeding supply kit, ensuring that all necessary components are included.
2. Verify the patient’s enteral feeding requirements and the need for syringe feeding.
3. Administer the enteral feeding using the syringe and the provided administration set tubing.
4. Monitor the patient’s response and tolerance to the enteral feeding.
5. Document the procedure and any relevant observations or complications.

4. When to use HCPCS code B4164

HCPCS code B4164 should be used when providing enteral feeding through syringe administration on a daily basis. It is important to ensure that the patient meets the specific criteria for enteral feeding and that syringe feeding is the appropriate method for their nutritional needs. The code should only be used for patients who require this specific type of enteral feeding and not for other methods or supplies.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4164, healthcare providers need to document the medical necessity for enteral feeding through syringe administration. This may include the patient’s medical condition, the inability to consume food orally, and the need for specialized enteral feeding. Additionally, providers should include detailed documentation of the components used from the enteral feeding supply kit, such as the feeding/flushing syringe, administration set tubing, dressings, and tape.

6. Historical Information and Code Maintenance

HCPCS code B4164 was added to the Healthcare Common Procedure Coding System on January 01, 1986. 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 to note that this code has been in use for a significant period of time, providing consistent identification and billing for enteral feeding supply kits for syringe feeding.

7. Medicare and Insurance Coverage

HCPCS code B4164 is eligible for coverage under Medicare and other insurance providers. The pricing indicator code 39 indicates that it falls under the parenteral and enteral nutrition category. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. Healthcare providers should review the specific coverage policies of Medicare and other insurers to ensure proper reimbursement for the enteral feeding supply kit.

8. Examples

Here are five examples of when HCPCS code B4164 should be billed:

1. A patient with a gastrointestinal disorder requiring enteral feeding through syringe administration.
2. A patient with dysphagia unable to consume food orally, necessitating enteral feeding via syringe.
3. A patient undergoing a medical procedure that temporarily restricts oral intake, requiring enteral feeding through syringe administration.
4. A patient with a neurological condition affecting swallowing, necessitating enteral feeding using a syringe.
5. A patient with a severe illness or injury unable to consume food orally, requiring enteral feeding through syringe administration for nutritional support.