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BETA v.3.0

2025 HCPCS code B4180

Homemix parenteral nutrition solution with >50% dextrose, 500 mL unit.

Ensure the correct code is used based on the dextrose concentration. Be mindful of documentation requirements and medical necessity justification.

Modifiers may be applicable depending on the specific circumstances of the administration and any associated services.

Medical necessity must be clearly documented for reimbursement. This includes justification for parenteral nutrition and the high dextrose formula, along with failed attempts at other nutritional interventions if applicable.

Administered for patients with impaired digestive function requiring intravenous nutrition. The formula is mixed at home and contains a high concentration of dextrose.Medicare covers this if properly documented as medically necessary.

IMPORTANT:For solutions with 50% or less carbohydrate, use B4164.

In simple words: This code is for a special type of intravenous feeding formula that is mixed at home. It contains more than 50% sugar and is given to patients who can't digest food normally.It's provided in 500 mL units.

Parenteral nutrition solution, carbohydrates, dextrose, greater than 50 percent, 500 mL = 1 unit, homemix. This code represents a homemix parenteral nutrition solution containing more than 50% carbohydrate as dextrose, supplied in units of 500 mL and administered parenterally.

Example 1: A patient with short bowel syndrome requires long-term parenteral nutrition and uses a homemix solution with a higher dextrose concentration due to specific metabolic needs., A patient with Crohn's disease experiences a severe flare-up and requires temporary parenteral nutrition while their digestive system recovers.They opt for a homemix solution for greater flexibility., A patient undergoing chemotherapy experiences severe nausea and vomiting, preventing adequate oral intake. They receive temporary parenteral nutrition with a high dextrose homemix solution to maintain caloric intake.

Documentation should support the medical necessity of parenteral nutrition and the specific need for the higher dextrose concentration. This might include details of the underlying condition, digestive impairment, nutritional assessments, and treatment plans.

** This high-dextrose solution is less common than the 50% or less option. Always confirm the solution's composition before coding.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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