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HCPCS
B4105

HCPCS Code B4105

Official Description

In-line cartridge containing digestive enzyme(s) for enteral feeding, each
Short Descr Enzyme cartridge enteral nut
Coverage Carrier Priced
Pricing Indicator(s) 39 – Supplies And Surgical Dressings - Parenteral and Enteral Nutrition
MPI A – Not applicable, as HCPCS priced under one methodology
Cross-Reference(s) Q9994
BETOS O1C – Enteral and parenteral
TOS Code(s) E – Enteral/parenteral nutrients/supplies
Added Date 1/1/2019
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
KX Requirements specified in the medical policy have been met
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
Date
Action
Notes
2019-01-01 Added Added
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