| HCPCS Code: |
B4157 |
| Long Description: |
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 |
| Short Description: |
Ef special metabolic inherit |
| Pricing Indicator 1: |
39 (Parenteral and Enteral Nutrition) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Coverage Issues Manual 1: |
65-10 |
| Statute Number: |
|
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
O1C (Enteral and parenteral) |
| Type of Service Code 1: |
E (Enteral/parenteral nutrients/supplies (effective 04/95)) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2005 |
| Action Effective Date: |
01-01-2005 |
| Action Code: |
N (No maintenance for this code) |
