HCPCS Codes for Enteral/parenteral nutrients/supplies


  • B4034

    Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
  • B4035

    Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
  • B4036

    Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
  • B4081

    Nasogastric tubing with stylet
  • B4082

    Nasogastric tubing without stylet
  • B4083

    Stomach tube - levine type
  • B4087

    Gastrostomy/jejunostomy tube, standard, any material, any type, each
  • B4088

    Gastrostomy/jejunostomy tube, low-profile, any material, any type, each
  • B4100

    Food thickener, administered orally, per ounce
  • B4102

    Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
  • B4103

    Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
  • B4104

    Additive for enteral formula (e.g., fiber)
  • B4105

    In-line cartridge containing digestive enzyme(s) for enteral feeding, each
  • B4148

    Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
  • B4149

    Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4150

    Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4152

    Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4153

    Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4154

    Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4155

    Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4157

    Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4158

    Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4159

    Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4160

    Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4161

    Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4162

    Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
  • B4164

    Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix
  • B4168

    Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix
  • B4172

    Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) - home mix
  • B4176

    Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix
  • B4178

    Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix
  • B4180

    Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix
  • B4185

    Parenteral nutrition solution, not otherwise specified, 10 grams lipids
  • B4187

    Omegaven, 10 grams lipids
  • B4189

    Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix
  • B4193

    Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix
  • B4197

    Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix
  • B4199

    Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix
  • B4216

    Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day
  • B4220

    Parenteral nutrition supply kit; premix, per day
  • B4222

    Parenteral nutrition supply kit; home mix, per day
  • B4224

    Parenteral nutrition administration kit, per day
  • B5000

    Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix
  • B5100

    Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix
  • B5200

    Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix
  • B9998

    Noc for enteral supplies
  • B9999

    Noc for parenteral supplies
  • Q9994

    In-line cartridge containing digestive enzyme(s) for enteral feeding, each