2024 HCPCS Code 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
TAGS: intact calories nutritionally enteral vitamins fiber through feeding include administered based complete
| Short Description | Ef ped complete soy based |
| HCPCS Coverage Code | D - Special coverage instructions apply |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Action Effective Date | January 01, 2005 |
| HCPCS Code Added Date | January 01, 2005 |
| HCPCS Pricing Indicator Code | 46 - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts) |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Issues Manual Reference Section Number | 65-10 |
| HCPCS Type Of Service Code | E - Enteral/parenteral nutrients/supplies (eff 04/95) |
| HCPCS Anesthesia Base Unit Quantity | 0 |
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