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2025 HCPCS code S9364

Home infusion therapy, total parenteral nutrition (TPN); administrative, pharmacy services, care coordination, supplies, and equipment, per diem.

This code is for non-Medicare payers only and should not be used in conjunction with codes S9365 through S9379.Always consult the payer's specific guidelines for coding and billing.

Modifiers may apply depending on the circumstances.Consult payer-specific guidelines for modifier application rules.

Medical necessity for home TPN is established when the patient is unable to receive adequate nutrition via the oral route due to conditions such as severe gastrointestinal disorders, cancer therapy side effects, or significant bowel resection.This decision requires documentation showing that the benefits of home TPN outweigh the risks and that the patient has the appropriate support system at home.Individual payer requirements for medical necessity documentation must be confirmed.

The clinical responsibility includes the oversight of the TPN therapy, including initial assessment, ongoing monitoring, and management of potential complications.The provider is responsible for ordering, administering, and documenting the treatment.Pharmacy services and nursing care are usually considered separately billable.

IMPORTANT:Do not use this code with S9365-S9379.Other codes may be needed for separately billable services such as nursing visits or specific medications.

In simple words: This code covers the daily cost of giving a patient nutrition through an IV at home.It includes all the services and supplies needed, such as the special formula, medication, and care coordination.

This HCPCS code encompasses home infusion therapy for total parenteral nutrition (TPN), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment.The standard TPN formula includes lipids, specialty amino acid formulas, and drugs not part of the standard formula. Nursing visits are separately coded. Reimbursement is on a per diem basis.This code should not be used with codes S9365-S9379.

Example 1: A patient with severe Crohn's disease requiring TPN for nutritional support at home due to bowel obstruction. This would include daily administration of the TPN, along with monitoring for complications., A cancer patient undergoing chemotherapy with severe mucositis preventing oral intake.The physician orders home TPN to provide the patient with adequate nutrition during this period.This scenario requires careful monitoring for electrolyte imbalances and infection., A patient who has had extensive bowel resection and is unable to absorb nutrients orally.Home TPN ensures adequate nutritional intake for healing and prevents malnutrition. The patient requires regular laboratory monitoring.

* Physician order for TPN* Detailed documentation of patient's nutritional needs* Comprehensive assessment of the patient's home environment to ensure safe administration.* Detailed record-keeping of the daily TPN infusion, including volume, formula composition, and any adverse events.* Documentation of nursing visits and care provided.* Pharmacy documentation related to compounding and supplying the TPN.

** This code is a temporary HCPCS code used by some commercial payers and state Medicaid programs.Medicare does not recognize this code.

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