2025 HCPCS code S9368
(Active) Effective Date: N/A Revision Date: N/A Pharmacy Services - Parenteral Nutrition Home Infusion Therapy Feed
Home infusion therapy; total parenteral nutrition (TPN); more than three liters per day; includes administrative, pharmacy services, care coordination, and supplies.
Modifiers may be applicable depending on circumstances and payer rules. Consult payer guidelines for any required modifiers. Example modifiers might include those for place of service or technical component (TC).
Medical necessity for home TPN must be documented, demonstrating the patient's inability to receive adequate nutrition via the GI tract due to illness or surgery. Supporting documentation could include lab values, nutritional assessments, and clinical progress notes.This would also need to comply with payer-specific medical necessity policies.
Home infusion pharmacy and potentially nurses (billed separately).
In simple words: This code covers the daily cost of getting TPN (nutrients given through a vein) at home, if you need more than three liters a day. It includes the pharmacy's work, managing your care, and all the supplies needed.Extra things like special formulas or nursing visits are billed separately.
This HCPCS code represents home infusion therapy for total parenteral nutrition (TPN) exceeding three liters daily.It encompasses administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, including standard TPN formula. Lipids, specialty amino acid formulas, and drugs not included in the standard formula are coded separately, as are nursing visits.The code is billed per diem (daily).
Example 1: A patient with severe Crohn's disease requiring bowel rest receives over 3 liters of TPN daily at home. S9368 is billed daily for the TPN infusion and related services, with separate codes for nursing visits and any specialty TPN components., A patient recovering from major abdominal surgery with significant malabsorption receives home TPN therapy.The pharmacy bills S9368 daily for the TPN solution, and the nursing agency bills separately for their home visits (99601/99602)., A patient with esophageal cancer requiring nutritional support is discharged home on TPN. The physician orders a specific TPN formula requiring separate billing for the formula's unique components.S9368 is used to bill for the daily infusion and coordination of the home TPN, while additional HCPCS B-codes will be used to report the specific components of the TPN solution. Nursing visits are separately reported.
Physician order for home TPN specifying volume, formula, and frequency.Documentation of daily administration of TPN.Documentation of any additional components of the TPN and separate billing for those components.Documentation of nursing visits if performed.
** This code is primarily for use by private payers and is not reimbursable under Medicare.Always verify payer specific coverage policies before billing this code.Separate billing is required for lipids, specialty amino acid formulas, drugs not in the standard formula, and nursing visits.The use of iFrameAI is recommended for a constantly updated database of medical codes.
- RVU: Information on RVUs is not readily available in the provided text.Further research into specific payer fee schedules would be required for this data.Consult iFrameAI for more accurate information.
- Global Days: This code is billed per diem, meaning each day of TPN infusion is a separate billable unit. There is no global period.
- Payment Status: Active for non-Medicare payers
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code as it's bundled with the professional component.
- Fee Schedule: Historical fee schedule data is not provided.Consult payer-specific fee schedules and pricing databases.
- Specialties:Home healthcare, oncology, gastroenterology, surgery
- Place of Service:Home