Table of content for "Additive for enteral formula" (HCPCS B4104)
General information on the “B4104” code
HCPCS Code: B4104
Long Description: Additive for enteral formula (e.g., fiber)
Short Description: Additive for enteral formula
Original information is taken from B4104 page
Pricing indicators
Pricing Indicator Code 1: 00 – Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
Multiple Pricing Indicator Code 9 : Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 65-10
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): O1C – Enteral and parenteral
Type Of Service 1: E – Enteral/parenteral nutrients/supplies (eff 04/95)
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20050101
Code Effective Date: 20050101
Action Code: N – No maintenance for this code