2025 HCPCS code B4164
(Retired) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Nutritional Products - Parenteral Nutrition Solutions Parenteral Solutions and Supplies Feed
Homemix parenteral nutrition solution; carbohydrates (dextrose), 50% or less (500 mL = 1 unit).
Parenteral nutrition is medically necessary when the gastrointestinal tract cannot adequately absorb nutrients.Documentation must justify the need for this specific type of homemix solution (low dextrose) based on the patient's clinical condition and nutritional needs.The solution must be formulated to meet the patient's specific metabolic and nutritional requirements and must be consistent with accepted standards of practice.
The physician is responsible for ordering and monitoring the parenteral nutrition, ensuring appropriate composition and verifying medical necessity.A registered dietician may assist in formulating the solution.
- Parenteral Solutions and Supplies
- B4034-B9999 > Parenteral Solutions and Supplies > B4164-B5200
In simple words: This code is for a special, at-home intravenous (IV) feeding solution made with sugar (dextrose) and other ingredients. It's used when a patient's digestive system isn't working properly, and the solution is given through a vein using a catheter.Medicare covers this only if a doctor says it's medically necessary.
This HCPCS code, B4164, represents a homemix parenteral nutrition solution containing 50% or less carbohydrate as dextrose, supplied in 500 mL units.It's administered intravenously and is used for patients with impaired digestive function. Medicare coverage requires documentation of medical necessity.
Example 1: A patient with short bowel syndrome requiring long-term parenteral nutrition. The dietician, in consultation with the physician, formulates a homemix solution with less than 50% dextrose to manage the patient's nutritional needs., A patient recovering from severe pancreatitis with ongoing digestive issues.A homemix parenteral nutrition solution, low in dextrose, is prescribed to support nutritional needs while the gut recovers., A patient with severe Crohn's disease undergoing a flare-up with significant malabsorption.A low-dextrose homemix solution is part of a comprehensive treatment plan to manage nutritional deficiencies.
* Detailed patient history indicating the reason for parenteral nutrition (e.g., short bowel syndrome, severe pancreatitis, Crohn's disease).* Complete nutritional assessment documenting the patient's needs and the rationale for the specific dextrose concentration.* Physician's order specifying the exact composition of the homemix solution, including dextrose percentage.* Documentation of patient's tolerance to the solution, including monitoring of electrolytes, glucose levels, and any adverse events.* Documentation of ongoing medical necessity for parenteral nutrition.
** This code is specifically for homemix solutions prepared by the patient or caregiver under the direction of a healthcare professional.Pharmacy-prepared solutions would require a different HCPCS code.The code is retired; please refer to current HCPCS codes for similar services.
- Payment Status: Inactive
- Specialties:Gastroenterology, Surgery, Oncology, Critical Care
- Place of Service:Home