2025 HCPCS code S9367
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Pharmacy Services - Home Infusion Therapy - Total Parenteral Nutrition (TPN) S9325-S9379 (Home Infusion Therapy) Feed
Home infusion therapy; total parenteral nutrition (TPN); more than two liters but no more than three liters per day; includes administrative services, professional pharmacy services, care coordination, and supplies.
Modifiers may be applicable depending on the circumstances of service.Consult the specific payer's guidelines for appropriate modifier use.
Medical necessity for TPN is established by the presence of a medical condition that prevents adequate nutrition through the GI tract. Documentation should clearly demonstrate the patient's inability to meet nutritional needs via oral or enteral routes and the clinical benefit of TPN therapy.
The clinical responsibility for this code falls primarily on the home infusion pharmacy and potentially collaborating physicians who prescribe and monitor the TPN therapy.Nursing staff may also be involved in the administration and monitoring of the infusion.The pharmacy coordinates the care, manages the supplies, and ensures the accuracy of the formula based on physician orders.
In simple words: This code covers the daily cost of getting nutrition through an IV at home, when the patient needs between two and three liters of special nutrient fluid. This includes the cost of managing the process, providing the fluid, coordinating the care, and supplying all necessary equipment.Additional charges may apply for extra ingredients or nursing visits.
This HCPCS code, S9367, represents home infusion therapy for total parenteral nutrition (TPN) where the patient receives more than two liters but no more than three liters of TPN fluid daily.The code encompasses administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, including the standard TPN formula.However, it excludes separately billable components such as lipids, specialty amino acid formulas, drugs outside the standard formula, and nursing visits.These must be coded separately using appropriate HCPCS or CPT codes.
Example 1: A patient with severe Crohn's disease requiring bowel rest is prescribed TPN at home. They require between 2 and 3 liters daily, requiring code S9367 for the TPN supply and separate billing for nursing visits (CPT 99601/99602)., A cancer patient undergoing chemotherapy experiences severe nausea and vomiting.They are placed on TPN for nutritional support, and code S9367 is used to cover the daily TPN administration.Separate codes would be used for any added medication, lipids, or other components., A patient recovering from extensive bowel surgery requires complete bowel rest and total parenteral nutrition. They are prescribed a custom TPN formula that requires separate coding of the formula components (HCPCS B codes) in addition to code S9367 for the administration services.
Physician order for TPN, specifying volume and formula.Documentation of patient's clinical condition necessitating TPN.Records of administration of TPN, including dates, times and volumes.Detailed records of all components of the TPN, using HCPCS B-codes as needed.Documentation of nursing visits if separately billed.
** This HCPCS code is not recognized by Medicare.Always verify coverage and reimbursement policies with the specific payer before billing.
- RVU: RVUs are not directly associated with HCPCS codes. Reimbursement is determined by the payer's specific fee schedule and may vary by location and provider type.
- Global Days: This code is billed per diem (daily).
- Payment Status: Active (for non-Medicare payers)
- Modifier TC rule: Not applicable.This code is comprehensive.
- Fee Schedule: Fee schedules for this code vary depending on the payer and location.Check with your payer for their current fee schedule.
- Specialties:Home healthcare, oncology, gastroenterology, surgery
- Place of Service:Home