How To Use HCPCS Code B4193

HCPCS code B4193 describes the enteral feeding supply kit for syringe feeding, per day. This code is used to identify the specific supplies and equipment needed for enteral feeding via syringe. In this article, we will explore the details of HCPCS code B4193, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS B4193?

HCPCS code B4193 is used to identify the enteral feeding supply kit for syringe feeding, per day. It includes various components such as feeding/flushing syringe, administration set tubing, dressings, and tape. This code is specific to enteral feeding via syringe and should not be used for other methods of enteral feeding.

2. Official Description

The official description of HCPCS code B4193 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 sol 52-73 gm prot.”

3. Procedure

1. Prepare the enteral feeding supply kit, ensuring that all necessary components are included.
2. Connect the administration set tubing to the feeding/flushing syringe.
3. Clean the patient’s feeding site and apply dressings as needed.
4. Insert the syringe into the feeding tube and administer the enteral feeding solution.
5. Flush the feeding tube with the appropriate amount of water or saline solution.
6. Secure the feeding tube and dressings with tape.

4. When to use HCPCS code B4193

HCPCS code B4193 should be used when providing enteral feeding via syringe. It is important to ensure that the patient meets the eligibility criteria for enteral feeding and that syringe feeding is the appropriate method for their specific condition. This code should not be used for other methods of enteral feeding, such as gravity feeding or pump feeding.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4193, healthcare providers should ensure that the following documentation is included:

• Documentation of the patient’s eligibility for enteral feeding
• Documentation of the medical necessity for syringe feeding
• Itemized list of the components included in the enteral feeding supply kit
• Date and duration of the enteral feeding

Providers should follow the appropriate billing guidelines and submit the claim with the necessary supporting documentation to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code B4193 was added to the Healthcare Common Procedure Coding System on January 01, 1988. It has an effective date of January 01, 2002. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The code falls under the pricing indicator code 39, which represents parenteral and enteral nutrition.

7. Medicare and Insurance Coverage

HCPCS code B4193 is eligible for coverage under Medicare. The pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. This means that the reimbursement for this code is determined by a different pricing methodology, such as a fee schedule or a negotiated rate with the insurer. Healthcare providers should verify the coverage and reimbursement policies of other insurance companies to ensure proper billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code B4193 should be billed:

1. A patient with a gastrointestinal disorder requires enteral feeding via syringe for a period of 7 days. The enteral feeding supply kit, including the feeding/flushing syringe, administration set tubing, dressings, and tape, is provided each day.
2. An elderly patient with dysphagia needs enteral feeding via syringe for a duration of 14 days. The enteral feeding supply kit is provided daily, including all necessary components.
3. A pediatric patient with a congenital anomaly requires long-term enteral feeding via syringe. The enteral feeding supply kit is provided on a monthly basis, with all components included.
4. A patient undergoing chemotherapy experiences difficulty swallowing and requires enteral feeding via syringe for a period of 5 days. The enteral feeding supply kit is provided each day, ensuring the patient’s nutritional needs are met.
5. A patient with a severe burn injury needs enteral feeding via syringe during their hospital stay. The enteral feeding supply kit is provided for the duration of their hospitalization, including all necessary components.