2025 HCPCS code B4149
(Active) Effective Date: N/A Revision Date: N/A Nutritional Products - Enteral Formulas and Additives Enteral and Parenteral Therapy Feed
Supply of manufactured blenderized natural food enteral formula (100 calories/unit).
Modifiers may apply depending on the circumstances of service.Consult the NCCI edits for guidance.
The patient must have a medical condition preventing them from obtaining adequate nutrition orally, requiring the use of an enteral feeding tube. Documentation should detail the specific condition and the appropriateness of this formula based on the patient's individual needs.
Physicians or other qualified healthcare providers who prescribe and administer enteral nutrition therapy are responsible for this code.Dieticians may also be involved in selecting and monitoring the appropriateness of the formula.
In simple words: This code covers a special type of liquid food given through a feeding tube.It's made from blended natural foods and provides nutrition for people who can't eat normally. The cost is based on the number of calories.
This HCPCS code, B4149, represents the supply of a manufactured enteral formula composed of blenderized natural foods.The formula contains intact nutrients including proteins, fats, carbohydrates, vitamins, minerals, and may include fiber.It's administered via a feeding tube into the stomach or small intestine and is billed in units of 100 calories.The formula must be manufactured, not prepared by the patient or caregiver.Medicare coverage requires documentation of medical necessity.
Example 1: A patient recovering from a stroke has difficulty swallowing and requires enteral nutrition.A dietician recommends a blenderized natural food formula, and the physician orders B4149 for its administration via a nasogastric tube., A patient with esophageal cancer is unable to consume adequate nutrition orally.The physician orders B4149 to provide complete nutrition via a jejunostomy tube, along with close monitoring from a registered dietitian., A patient with severe Crohn's disease experiences malabsorption and weight loss. The physician orders a specific B4149 formula, determined by a nutritional assessment, to meet the patient's individual nutrient needs, delivered via a gastrostomy tube.
Physician's order specifying the formula, medical necessity documentation outlining the patient's inability to consume adequate nutrition orally, and evidence supporting the choice of this specific formula (e.g., dietary assessment, laboratory results).
** Prior authorization may be required by some payers.The code is for the supply of the formula only; separate codes are needed for the provision of the feeding tube and administration of the formula.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Gastroenterology, Oncology, Surgery, Critical Care, Geriatrics, Nutrition Support
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Home, Other Place of Service (depending on specific clinical setting)