B4153 HCPCS - 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

Code Information

HCPCS Code: B4153
Sequence Number: 0010
Short Description: Ef hydrolyzed/amino acids
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
Date Added: 1/1/1986
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	B4153
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, 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
HCPCS Short Description	Ef hydrolyzed/amino acids
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	1/1/1986
HCPCS Action Effective Date	1/1/2005
HCPCS Action Code	N - No maintenance for this code