B4152 HCPCS - ENTERAL FORMULA, NUTRITIONALLY COMPLETE, CALORICALLY DENSE (EQUAL TO OR GREATER THAN 1.5 KCAL/ML) WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT

Code Information

HCPCS Code: B4152
Sequence Number: 0010
Short Description: Ef calorie dense>/=1.5kcal
Long Description: Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
Date Added: 1/1/1984
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2005
Classification: Enteral and Parenteral Therapy
Coding System: HCPCS

Pricing Indicator Code:
- 39 - Parenteral and Enteral Nutrition
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
- 65-10
Medicare Carriers Manual Reference Section Number:
- 2130
- 4450
Coverage Code: D - Special coverage instructions apply

Field Name	Field Value
Healthcare Common Procedure Coding System Code	B4152
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	Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
HCPCS Short Description	Ef calorie dense>/=1.5kcal
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 Issues Manual Reference Section Number 1	65-10
HCPCS Medicare Carriers Manual Reference Section Number 1	2130
HCPCS Medicare Carriers Manual Reference Section Number 2	4450
HCPCS Coverage Code	D - Special coverage instructions apply
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	1/1/1984
HCPCS Action Effective Date	1/1/2005
HCPCS Action Code	N - No maintenance for this code