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BETA v.3.0

2025 HCPCS code B4197

Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins; including preparation; any strength; 74-100 grams of protein; premix.

Ensure accurate documentation of the solution's composition, including the amount of protein, carbohydrates, electrolytes, trace elements, and vitamins.Follow payer-specific guidelines regarding medical necessity and appropriate billing practices.

Modifiers may be applicable depending on the circumstances of service. Consult current modifier guidelines for specifics.

Parenteral nutrition is medically necessary when the patient's gastrointestinal tract is unable to absorb sufficient nutrients to meet metabolic demands.Documentation must support the inability to meet nutritional requirements via enteral routes (e.g., oral or nasogastric).

A physician or other qualified healthcare provider is responsible for ordering and monitoring the administration of parenteral nutrition. A registered dietitian may assist in formulating the solution's composition based on the patient's individual needs.

IMPORTANT:For parenteral nutrition solutions with different protein amounts, refer to codes B4189-B4199.

In simple words: This code covers a special intravenous (IV) feeding solution given to people whose bodies can't properly digest food.It contains protein, sugars, and other important nutrients to help them stay healthy.

This HCPCS code, B4197, represents a premixed parenteral nutrition solution.The solution is compounded from amino acids and carbohydrates, and further supplemented with electrolytes, trace elements, and vitamins.The solution contains 74 to 100 grams of protein and is administered intravenously. Preparation of the solution is included in the code.

Example 1: A patient recovering from major bowel surgery is unable to digest food orally.The physician orders parenteral nutrition (B4197) to provide adequate nutrition until bowel function is restored., A patient with short bowel syndrome experiences severe malabsorption. Long-term parenteral nutrition (B4197) is prescribed to supplement nutritional deficiencies., A critically ill patient in the ICU requires intensive nutritional support.B4197 is used as part of a comprehensive treatment plan, adjusted according to daily lab values and clinical assessment.

* Physician's order specifying the exact composition of the parenteral nutrition solution.* Patient's medical history, including any allergies or contraindications.* Lab results showing electrolyte balance, nutritional deficiencies, and other relevant metabolic parameters.* Detailed documentation of the solution's preparation and administration.* Regular monitoring of the patient's response to therapy, including weight, lab values, and clinical observations.

** This code includes the preparation of the solution.Always verify the specific requirements of the payer for proper reimbursement.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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