2025 HCPCS code B4168
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Parenteral Solutions and Supplies Enteral and Parenteral Therapy Feed
Parenteral nutrition solution; amino acid, 3.5%, homemix, 500 mL.
Modifiers may be applicable depending on the circumstances of service. Consult the CMS National Correct Coding Initiative (NCCI) edits and your payer's guidelines for specific modifier rules.
Medical necessity for B4168 is established when a patient's digestive system is unable to absorb sufficient nutrients through the gastrointestinal tract. This necessitates intravenous nutritional support to maintain adequate nutritional status, prevent malnutrition, and support healing and recovery.
Registered dietitians and physicians collaborate in the management and monitoring of patients receiving parenteral nutrition, including assessment of nutritional needs, formulation of the solution, and monitoring for complications.
In simple words: This code is for a special intravenous (IV) feeding solution that a patient mixes at home. It's used when someone can't get enough nutrition through eating normally. The solution contains amino acids, which are building blocks for the body.Medicare will only pay for it if the doctor says it's really needed.
This HCPCS code, B4168, represents a homemix parenteral nutrition solution containing 3.5% amino acids, supplied in 500 mL units.This solution is administered parenterally (intravenously) to patients with compromised digestive systems. The patient mixes the ingredients at home under the guidance of a healthcare provider.Medicare coverage is contingent upon documented medical necessity.
Example 1: A patient with Crohn's disease experiencing severe malnutrition and malabsorption is prescribed B4168 for home parenteral nutrition to provide adequate nutritional support while their digestive system heals., A patient recovering from extensive bowel resection surgery requires long-term parenteral nutrition.B4168 is used as part of a phased approach to gradually reduce the reliance on parenteral nutrition while transitioning to enteral or oral feeding as tolerated., A patient with short bowel syndrome has insufficient absorptive capacity in their intestines and requires long-term home parenteral nutrition. B4168 is chosen based on the patient's individual nutritional requirements and is part of a comprehensive treatment plan that includes regular monitoring of their laboratory values and clinical status.
Detailed medical history, including the cause of digestive dysfunction; complete nutritional assessment; physician's order specifying the formulation of B4168; documentation of patient education on the preparation and administration of the solution; regular monitoring of patient's weight, lab values (electrolytes, albumin, etc.), and clinical condition.
** Always refer to the most up-to-date HCPCS codebook and payer guidelines for complete and accurate coding and billing practices. This information is for educational purposes only and does not constitute medical or billing advice.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Gastroenterology, Nutritional Support, Surgery
- Place of Service:Home