In simple words: This code represents a feeding formula given through a feeding tube that contains all the necessary nutrients a person needs, like proteins, fats, carbs, vitamins, and minerals. It might also have fiber.It's for people who can't eat enough by mouth. Each unit of the code is equal to 100 calories of the formula.

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit.

Example 1: A patient with dysphagia following a stroke requires a feeding tube and is prescribed a standard, nutritionally complete enteral formula., A patient with a bowel obstruction requires enteral feeding and receives B4150 to maintain nutritional needs. , A patient with cystic fibrosis has difficulty absorbing nutrients and is given B4150 as a supplemental feeding along with pancreatic enzyme supplementation.

Medical record documentation should support the medical necessity of the enteral feeding, specifying why the patient cannot maintain adequate oral nutrition. The type of formula, method of administration, and the patient's tolerance should also be documented.

** While previously prior authorization was often required for enteral formulas, some payers, like AmeriHealth Caritas New Hampshire, have removed this requirement. It is always crucial to verify coverage and prior authorization requirements with the specific payer before providing services.The information provided is valid as of today, December 1st, 2024 and might be subject to change.For the most accurate and up-to-date information, consult iFrameAI.