2025 HCPCS code B4216
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Parenteral Solutions and Supplies Enteral and Parenteral Therapy Feed
Parenteral nutrition additives (vitamins, trace elements, heparin, electrolytes) for homemix, per day.
Modifiers may apply depending on the circumstances of service. Consult the HCPCS modifier guidelines for specific applications.
Medical necessity for code B4216 is established when a patient has a condition that prevents them from adequately absorbing nutrients through their digestive system.Documentation of the underlying condition, such as short bowel syndrome, Crohn's disease, or severe malabsorption, is crucial.The need for parenteral nutrition, including the specific additives, should be clearly demonstrated by clinical findings and laboratory data.
The clinical responsibility lies with the physician or other qualified healthcare provider who orders and monitors the parenteral nutrition therapy.This includes assessing the patient's nutritional needs, determining the appropriate composition of the solution, and monitoring for any complications.The provider should document the medical necessity of the therapy. The pharmacist may also have responsibility in the preparation and dispensing of the solution's components.
In simple words: This code covers extra ingredients (vitamins, minerals, and medicines) added to a special intravenous (IV) feeding solution that patients mix at home. This IV feeding is for people whose bodies can't digest food normally.The exact ingredients depend on the patient's needs.
This HCPCS code, B4216, encompasses the provision of vitamins, trace elements, heparin, and electrolytes as additives to a patient-prepared, home-mixed parenteral nutrition solution.A parenteral nutrition solution delivers nutrients intravenously to patients with compromised digestive systems. The solution's composition varies based on individual patient needs and includes amino acids, dextrose (sugar), and other nutrients. The patient combines these components to create the homemix solution, which can be administered via a central or peripheral vein. Medicare coverage requires documentation of medical necessity.
Example 1: A patient with Crohn's disease experiencing severe malabsorption requires long-term parenteral nutrition. The physician orders a daily homemix solution, including B4216 for essential vitamins and electrolytes to supplement the basic nutrient components., A patient recovering from extensive bowel resection surgery is unable to tolerate oral intake. Parenteral nutrition with code B4216 for added electrolytes and trace minerals is initiated to maintain hydration and electrolyte balance during recovery., A patient with short bowel syndrome is on long-term home parenteral nutrition. Regular adjustments to the solution's composition are required based on laboratory tests. Code B4216 covers the necessary additives to maintain the patient's nutritional status.
** This code is specifically for additives to a home-mixed parenteral nutrition solution.It does not cover the base nutrients of the solution itself.Correct documentation is paramount for reimbursement.
- Payment Status: Active
- Modifier TC rule: The application of TC modifiers may depend on whether the specific components of the solution are being furnished, therefore, always refer to the HCPCS manual and relevant payer guidelines.
- Specialties:Gastroenterology, Surgery, Oncology, Nutrition Support
- Place of Service:Home