Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit

B4158
HCPCS Code

2023 HCPCS
Billable/Valid Code

B4158 is a valid 2023 HCPCS Code that could be used to indicate Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit for reimbursement purposes.

B4158 belongs to Enteral/Parenteral Nutrients/Supplies Type of Service and has been in effect since Jan 01, 2005.

Short description for B4158 HCPCS code:

Ef ped complete intact nut

HCPCS B4158

B4158 code information

HCPCS code:	B4158
Description:	ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE WITH INTACT NUTRIENTS, INCLUDES PROTEINS, FATS, CARBOHYDRATES, VITAMINS AND MINERALS, MAY INCLUDE FIBER AND/OR IRON, ADMINISTERED THROUGH AN ENTERAL FEEDING TUBE, 100 CALORIES = 1 UNIT
Effective Date:	Jan 01, 2005
Added Date:	Jan 01, 2005
Termination Date:	HCPCS B4158 was terminated on Nov 30, -0001
Pricing indicator:	`46` - CARRIER PRICED (E.G., NOT OTHERWISE CLASSIFIED, INDIVIDUAL DETERMINATION, CARRIER DISCRETION, GAP-FILLED AMOUNTS)
Multi Pricing indicator:	`A` - NOT APPLICABLE AS HCPCS PRICED UNDER ONE METHODOLOGY
HCPCS CIM:	`65-10` HCPCS COVERAGE ISSUES MANUAL REFERENCE SECTION NUMBER(S)
Coverage code:	`D` - SPECIAL COVERAGE INSTRUCTIONS APPLY
BETOS code:	`O1C` - ENTERAL AND PARENTERAL
Action code:	`N` - NO MAINTENANCE FOR THIS CODE
Type of Service:	`E` - ENTERAL/PARENTERAL NUTRIENTS/SUPPLIES
Anesthesia BUQ:	0