| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9374 |
Home infusion therapy, hydration therapy; one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
5,256 |
1,604 |
$961K |
| S9366 |
Home infusion therapy, total parenteral nutrition (tpn); more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem |
3,749 |
571 |
$652K |
| 99601 |
|
8,473 |
3,397 |
$620K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
15,094 |
10,812 |
$553K |
| S9379 |
Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
7,238 |
1,744 |
$504K |
| S9500 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
4,294 |
1,835 |
$478K |
| S9365 |
Home infusion therapy, total parenteral nutrition (tpn); one liter per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem |
2,342 |
262 |
$441K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
3,401 |
1,474 |
$329K |
| S9502 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 8 hours, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
2,428 |
1,020 |
$296K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
30,765 |
21,652 |
$231K |
| J1561 |
Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg |
137 |
88 |
$142K |
| S9338 |
Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
2,622 |
1,765 |
$126K |
| S9501 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 12 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
2,097 |
746 |
$124K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,733 |
2,258 |
$117K |
| S9375 |
Home infusion therapy, hydration therapy; more than one liter but no more than two liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,295 |
279 |
$105K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
1,248 |
363 |
$91K |
| J1559 |
Injection, immune globulin (hizentra), 100 mg |
545 |
294 |
$85K |
| J1569 |
Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg |
199 |
121 |
$84K |
| S9367 |
Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem |
427 |
58 |
$72K |
| 99602 |
Nursing care in home rn |
1,562 |
914 |
$69K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,517 |
1,367 |
$63K |
| S5501 |
Home infusion therapy, catheter care / maintenance, complex (more than one lumen), includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,053 |
582 |
$52K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
5,795 |
4,067 |
$46K |
| S5502 |
Home infusion therapy, catheter care / maintenance, implanted access device, includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem (use this code for interim maintenance of vascular access not currently in use) |
1,914 |
1,556 |
$41K |
| S9123 |
Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) |
967 |
431 |
$38K |
| J0878 |
Injection, daptomycin, 1 mg |
1,882 |
214 |
$38K |
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
19,959 |
18,344 |
$38K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
4,377 |
2,807 |
$33K |
| 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 |
2,234 |
1,762 |
$28K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
8,898 |
3,112 |
$25K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
4,513 |
2,161 |
$23K |
| J1335 |
Injection, ertapenem sodium, 500 mg |
986 |
435 |
$23K |
| B4224 |
Parenteral nutrition administration kit, per day |
925 |
260 |
$18K |
| J3490 |
Unclassified drugs |
830 |
217 |
$18K |
| 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 |
5,758 |
4,005 |
$18K |
| J1459 |
Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg |
60 |
39 |
$16K |
| S9503 |
Home infusion therapy, antibiotic, antiviral, or antifungal; once every 6 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
190 |
85 |
$13K |
| J1745 |
Injection, infliximab, excludes biosimilar, 10 mg |
237 |
229 |
$13K |
| J3370 |
Injection, vancomycin hcl, 500 mg |
2,050 |
875 |
$9K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
137 |
116 |
$7K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
607 |
259 |
$7K |
| S5498 |
Home infusion therapy, catheter care / maintenance, simple (single lumen), includes administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment, (drugs and nursing visits coded separately), per diem |
353 |
202 |
$7K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
419 |
352 |
$6K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
925 |
260 |
$6K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,258 |
955 |
$6K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,647 |
1,153 |
$5K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
331 |
288 |
$4K |
| J7030 |
Infusion, normal saline solution , 1000 cc |
941 |
405 |
$4K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
2,256 |
1,660 |
$3K |
| B4100 |
Food thickener, administered orally, per ounce |
1,542 |
1,293 |
$3K |
| S9542 |
Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
6,838 |
5,921 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,667 |
691 |
$3K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
4,683 |
3,589 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
966 |
400 |
$2K |
| J0692 |
Injection, cefepime hydrochloride, 500 mg |
668 |
295 |
$2K |
| B4104 |
Additive for enteral formula (e.g., fiber) |
1,516 |
1,290 |
$1K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
272 |
122 |
$1K |
| B9998 |
Noc for enteral supplies |
119 |
96 |
$393.96 |
| B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
869 |
705 |
$264.67 |
| B4081 |
Nasogastric tubing with stylet |
14 |
12 |
$257.01 |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
586 |
294 |
$99.52 |
| S9343 |
Home therapy; enteral nutrition via bolus; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
4,180 |
3,973 |
$91.90 |
| J7050 |
Infusion, normal saline solution, 250 cc |
447 |
213 |
$73.45 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
675 |
321 |
$8.06 |
| A4217 |
Sterile water/saline, 500 ml |
48 |
17 |
$5.38 |
| B4162 |
Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
208 |
175 |
$1.16 |
| A4211 |
Supplies for self-administered injections |
43 |
28 |
$0.96 |
| A4452 |
Tape, waterproof, per 18 square inches |
24 |
21 |
$0.60 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
72 |
62 |
$0.10 |
| J1438 |
Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
1,895 |
1,747 |
$0.00 |
| J1595 |
Injection, glatiramer acetate, 20 mg |
29 |
28 |
$0.00 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
18 |
13 |
$0.00 |
| J0135 |
Injection, adalimumab, 20 mg |
3,519 |
3,157 |
$0.00 |
| J2941 |
Injection, somatropin, 1 mg |
1,799 |
1,591 |
$0.00 |
| S9341 |
Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
607 |
545 |
$0.00 |
| B4157 |
Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
238 |
167 |
$0.00 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
58 |
26 |
$0.00 |