2025 HCPCS code B9998
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Enteral Supplies Nutrition Infusion Pumps and Supplies Not Otherwise Classified (NOC) Feed
Enteral supply item not otherwise classified; used when no specific HCPCS code exists.
Modifiers may apply depending on the specific circumstances and payer requirements.Consult payer guidelines for applicable modifiers.
The use of B9998 requires thorough documentation establishing the patient's inability to maintain adequate nutrition via oral intake.The documentation should clearly outline the clinical reasons for requiring the specific enteral supply, demonstrating the medical necessity of the item.
The physician or other qualified healthcare provider is responsible for ordering and justifying the medical necessity of the unlisted enteral supply.Documentation of the patient's condition requiring enteral nutrition and the specifics of the supplied item are crucial.
- Nutrition Infusion Pumps and Supplies Not Otherwise Classified (NOC)
- B9002-B9999 (Nutrition Infusion Pumps and Supplies Not Otherwise Classified)
In simple words: This code is for special feeding tube supplies when there isn't a specific code for the exact item needed.It's used for patients who can't eat normally and need feeding through a tube.Doctors must provide detailed information about what was given and why it was necessary.
HCPCS code B9998 represents an unlisted enteral supply item for patients unable to maintain adequate oral nutrition.This code is used when no other specific HCPCS code accurately reflects the supplied item.It requires detailed documentation specifying the item and justifying medical necessity.Enteral nutrition refers to feeding via a tube into the stomach or small intestine, used when oral intake is compromised.
Example 1: A patient with severe dysphagia (difficulty swallowing) requires a specialized enteral feeding tube and pump.B9998 is used with supporting documentation specifying the tube's type and the justification for its use., A patient recovering from oral surgery needs temporary enteral nutrition support.A specific enteral formula is used, but no dedicated HCPCS code exists.B9998 is used, with the NDC number of the formula and detailed clinical notes., A patient with Crohn's disease experiences severe malabsorption and requires a unique enteral formula not covered by existing HCPCS codes. The formula is billed using B9998 and the NDC number.Documentation outlining the patient's condition, formula composition, and medical necessity is provided.
* Detailed description of the enteral supply item.* NDC number (if applicable).* Justification for medical necessity.* Patient's medical record documenting the need for enteral nutrition.* Physician's order for the supply.
** Payers may have specific requirements for documentation and may require pre-authorization for the use of B9998.Always consult with the payer regarding their specific policies.
- Payment Status: Active
- Specialties:Gastroenterology, Surgery, Oncology, Nutrition Support
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Home Healthcare