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Official Description

Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day
Short Descr Parenteral nutrition additiv
Coverage Special coverage instructions apply
Pricing Indicator(s) 39 – Supplies And Surgical Dressings - Parenteral and Enteral Nutrition
MPI A – Not applicable, as HCPCS priced under one methodology
CIM 65-10
MCM 2130
BETOS O1C – Enteral and parenteral
TOS Code(s) E – Enteral/parenteral nutrients/supplies
Added Date 1/1/1984
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
IOM 100-02, 15, 120
OTS Orthotic No
CCS Clinical Classification 223 - Enteral and parenteral nutrition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
KX Requirements specified in the medical policy have been met
BO Orally administered nutrition, not by feeding tube
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
Date
Action
Notes
1984-01-01 Added Code added 1/1/1984
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