HCPCS Code B4158
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
| Short Description | Ef ped complete intact nut |
|---|---|
| Year | 2026 |
| Coverage Code | D = Special coverage instructions apply |
| Action Code | N = No maintenance for this code |
| Action Effective Date | January 01, 2005 |
| Code Added Date | January 01, 2005 |
| Pricing Indicator | 46 = Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap - filled amounts) |
| Type of Service | E = Enteral/parenteral nutrients/supplies (eff 04/95) |