2025 HCPCS code B4199
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Parenteral Solutions and Supplies Enteral and Parenteral Therapy Feed
B4199 represents a premixed parenteral nutrition solution with >100g protein, including amino acids, carbohydrates, electrolytes, trace elements, and vitamins; preparation included.
Modifiers may apply depending on the circumstances of service. Consult the HCPCS modifier guidelines for appropriate application.
Parenteral nutrition is medically necessary when a patient's gastrointestinal tract is unable to absorb sufficient nutrients to meet their metabolic needs due to disease, surgery, or injury.Documentation must clearly demonstrate the patient's inability to tolerate enteral nutrition and the need for intravenous nutritional support.
Administering parenteral nutrition requires a physician's order and may involve the work of registered dieticians. The physician is responsible for ordering and monitoring the patient's response to the therapy.Registered dietitians often assist in calculating nutrient requirements and monitoring patient tolerance. Nurses administer the solution.
In simple words: This code is for a special intravenous (IV) nutrient solution given to people whose bodies can't process food normally.It's a pre-mixed solution with lots of protein, sugars, and other important nutrients to help them stay healthy.The cost includes making the solution ready for use.
HCPCS code B4199 describes a premixed parenteral nutrition solution of any strength containing more than 100 grams of protein.The solution is composed of compounded amino acids and carbohydrates, along with electrolytes, trace elements, and vitamins.The code includes the preparation of the solution. Parenteral nutrition supplies nutrients intravenously to patients whose digestive tracts are non-functional. The specific nutrient composition varies depending on individual patient needs and available products.A typical solution combines compounded amino acids with dextrose (a sugar) to provide protein and carbohydrates. Additional nutrients are added as needed.A dose exceeding 100 grams of protein is sufficient to address severe nutritional deficiencies. Administration is via central or peripheral vein. Medicare coverage requires documentation of medical necessity.
Example 1: A patient with severe Crohn's disease and bowel obstruction requires parenteral nutrition for nutritional support while awaiting surgery. Code B4199 would be used to bill for the compounded solution with >100g protein., A patient recovering from major abdominal surgery with prolonged ileus (intestinal paralysis) needs long-term parenteral nutrition. B4199 would be used to bill for the ongoing provision of the high-protein solution., A patient with severe pancreatitis and inability to absorb nutrients orally requires high-protein parenteral nutrition support. Code B4199 would be appropriate for billing the solution provided.
Physician's order specifying the composition of the parenteral nutrition solution, including the amount of protein, carbohydrates, electrolytes, vitamins, and trace elements.Patient's medical history, including the reason for requiring parenteral nutrition, and laboratory results (e.g., albumin, pre-albumin levels) demonstrating nutritional deficiency. Documentation of preparation, administration, and monitoring of the solution, including any adverse reactions.
** This code is for a high-protein premixed solution.The exact composition should be documented in the patient's chart. The code includes the preparation of the solution, but not the administration.Consult payer guidelines for specific reimbursement policies.
- Payment Status: Active
- Specialties:Gastroenterology, Surgery, Oncology, Critical Care, Nutrition
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center