| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
B4088 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
| HCPCS Short Description |
Gastro/jejuno tube, low-pro |
| HCPCS Pricing Indicator Code 1 |
39 - Parenteral and Enteral Nutrition |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
C - Carrier judgment |
| HCPCS Berenson-Eggers Type Of Service Code |
O1C - Enteral and parenteral |
| HCPCS Type Of Service Code 1 |
E - Enteral/parenteral nutrients/supplies (eff 04/95) |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2008 |
| HCPCS Action Effective Date |
1/1/2016 |
| HCPCS Action Code |
N - No maintenance for this code |