Table of content for "Ef hydrolyzed/amino acids" (HCPCS B4153)
General information on the “B4153” code
HCPCS Code: B4153
Long Description: 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
Short Description: Ef hydrolyzed/amino acids
Original information is taken from B4153 page
Pricing indicators
Pricing Indicator Code 1: 39 – Parenteral and Enteral Nutrition. Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings .
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
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: 19860101
Code Effective Date: 20050101
Action Code: N – No maintenance for this code