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BETA v.3.0

2025 HCPCS code B4172

Parenteral nutrition solution; amino acid, 5.5% through 7%, homemix (500 mL units).

Appropriate documentation of medical necessity, including patient assessment, and the appropriateness of the amino acid concentration (5.5-7%) and total volume administered are critical for accurate coding and reimbursement.

Modifiers may apply depending on the circumstances of service delivery. Consult the CMS National Correct Coding Initiative (NCCI) for the most current coding guidelines.

Medical necessity is established through documented evidence of the patient's inability to absorb nutrients via the gastrointestinal tract.This may be due to conditions such as Crohn's disease, short bowel syndrome, severe malabsorption syndromes, or following major gastrointestinal surgery. Documentation must support the need for long-term parenteral nutrition and the specific amino acid concentration used.

Registered dietician and physician collaboration is crucial for appropriate patient selection, nutritional assessment, solution formulation, and monitoring of the parenteral nutrition therapy.The physician orders the therapy and monitors the patient's response. The registered dietician is often involved in the nutritional assessment and preparation of the homemix solution, and monitoring of the patient's nutritional status.

IMPORTANT:B4168 (3.5% amino acid solution), B4176 (7-8.5% amino acid solution), B4178 (>8.5% amino acid solution)

In simple words: This code is for a special, custom-made liquid food given through a vein. It's used for people who can't get enough nutrition through eating. The food mixture contains a specific amount of amino acids (building blocks of protein) and is given in 500 ml bags.

This HCPCS code, B4172, represents the administration of a homemix parenteral nutrition solution containing 5.5% to 7% amino acids, supplied in 500 mL units.This solution is administered intravenously to patients with compromised digestive function, requiring parenteral nutrition.Medicare coverage requires documentation of medical necessity.

Example 1: A patient with Crohn's disease experiencing severe malnutrition and bowel obstruction requiring long-term parenteral nutrition. The registered dietician works with the physician to determine the appropriate amino acid concentration and other nutritional components for the homemix solution., A patient recovering from extensive bowel resection surgery who cannot tolerate oral intake for an extended period. The physician orders B4172, and the registered dietician calculates the necessary components for the homemix solution., A patient with short bowel syndrome, needing long-term nutritional support, works with the registered dietician and physician to manage their home parenteral nutrition, with code B4172 used for reporting the specific amino acid concentration of their homemix solution.

Physician order specifying the amino acid concentration (5.5-7%), volume (500 mL units), and other nutritional components.Detailed patient history, nutritional assessment by a registered dietician, laboratory results (e.g., electrolytes, liver function tests), and ongoing monitoring of patient's response to therapy are essential.

** This code is specifically for homemix parenteral nutrition solutions.The concentration of amino acids must fall within the 5.5% to 7% range.Other codes exist for different amino acid concentrations.

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