Question 1

What is HCPCS code B4153?

Accepted Answer

HCPCS code B4153 is "Ef hydrolyzed/amino acids". 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

Question 2

What category is B4153 in?

Accepted Answer

B4153 belongs to HCPCS Category B (Enteral and Parenteral Therapy).

Question 3

When should I use HCPCS code B4153?

Accepted Answer

Use B4153 when billing for ef hydrolyzed/amino acids. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is B4153 covered by Medicare?

Accepted Answer

Coverage for B4153 (Ef hydrolyzed/amino acids) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for B4153?

Accepted Answer

Documentation for B4153 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).