2025 HCPCS Code B4103

Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit

TAGS: enteral clear replace fluids electrolytes
Short DescriptionEf ped fluid and electrolyte
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code D - Special coverage instructions apply
HCPCS Code Added Date January 01, 2005
HCPCS Action Effective Date January 01, 2005
HCPCS Pricing Indicator Code 46 - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)
HCPCS Type Of Service Code E - Enteral/parenteral nutrients/supplies (eff 04/95)
HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number 65-10

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