B4087 – Gastrostomy/jejunostomy tube, standard, any material, any type, each

Long description

Gastrostomy/jejunostomy tube, standard, any material, any type, each

Short description

Gastro/jejuno tube, std

Pricing indicator

39 Parenteral and enteral nutrition

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

O1C Enteral and parenteral

Added

January 1, 2008

Last change

January 1, 2008 – No change

Nearby B codes

• B4034 – Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4035 – Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4036 – Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4081 – Nasogastric tubing with stylet
• B4082 – Nasogastric tubing without stylet
• B4083 – Stomach tube - levine type
• B4088 – Gastrostomy/jejunostomy tube, low-profile, any material, any type, each
• B4100 – Food thickener, administered orally, per ounce
• B4102 – Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
• B4103 – Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit
• B4104 – Additive for enteral formula (e.g., fiber)
• B4105 – In-line cartridge containing digestive enzyme(s) for enteral feeding, each
• B4148 – Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape
• B4149 – Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit