How To Use HCPCS Code B4216

HCPCS code B4216 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 category of parenteral and enteral nutrition, and it is used to bill for the necessary supplies for enteral feeding.

1. What is HCPCS B4216?

HCPCS code B4216 is a specific code used to identify the enteral feeding supply kit for syringe feeding, per day. It is important to note that this code is only applicable for syringe feeding and not for other methods of enteral feeding. The code is used to accurately document and bill for the supplies required for enteral feeding procedures.

2. Official Description

The official description of HCPCS code B4216 is “Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape.” This description clearly outlines the components included in the enteral feeding supply kit for syringe feeding.

3. Procedure

1. Prepare the enteral feeding supply kit, ensuring that it includes a feeding/flushing syringe, administration set tubing, dressings, and tape.
2. Verify the patient’s enteral feeding requirements and ensure that syringe feeding is the appropriate method.
3. Administer the enteral feeding using the syringe and the provided administration set tubing.
4. Monitor the patient during the feeding process and make any necessary adjustments.
5. Document the enteral feeding procedure, including the date, time, and any relevant observations or complications.

4. When to use HCPCS code B4216

HCPCS code B4216 should be used when billing for the enteral feeding supply kit specifically for syringe feeding. It is important to ensure that the patient’s enteral feeding method aligns with the use of this code. If the patient is not receiving enteral feeding through syringe feeding, a different HCPCS code should be used to accurately reflect the method of administration.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code B4216, healthcare providers need to document the following information:

• Date of service
• Number of days the enteral feeding supply kit was provided
• Details of the enteral feeding procedure, including the method of administration (syringe feeding)
• Itemized list of the components included in the enteral feeding supply kit

Providers should ensure that the documentation accurately reflects the services provided and supports the medical necessity of the enteral feeding supply kit.

6. Historical Information and Code Maintenance

HCPCS code B4216 was added to the Healthcare Common Procedure Coding System on January 01, 1984. It has an effective date of January 01, 2002. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code B4216 is covered by Medicare and other insurance providers. The pricing indicator code 39 indicates that it falls under the category of parenteral and enteral nutrition. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. Providers should follow the specific billing guidelines and reimbursement policies of Medicare and other insurance carriers when submitting claims for HCPCS code B4216.

8. Examples

Here are five examples of scenarios where HCPCS code B4216 should be billed:

1. A patient with a feeding tube requires enteral feeding through syringe feeding for a period of 7 days.
2. An elderly patient with dysphagia receives enteral feeding via syringe feeding for 14 days following a stroke.
3. A child with a congenital gastrointestinal disorder requires enteral feeding through syringe feeding for 30 days.
4. A patient undergoing chemotherapy experiences difficulty swallowing and requires enteral feeding via syringe feeding for 5 days.
5. A critically ill patient in the intensive care unit requires enteral feeding through syringe feeding for an indefinite period of time.