B4187

Short Description

• Omegaven, 10 grams lipids

Procedure Note

• 0126 = NCD MANUAL 180.2.

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2020

HCPCS Code Added Date

• January 01, 2020

HCPCS Pricing Indicator Code

• 39 = Parenteral and Enteral Nutrition

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Type Of Service Code

• E = Enteral/parenteral nutrients/supplies (eff 04/95)

HCPCS Anesthesia Base Unit Quantity

• 0