Enteral Nutrition - Correct Coding and Billing
This Correct Coding and Billing publication is effective for claims with dates of service on or after November 12, 2020.
Enteral nutrition is covered under the Prosthetic Device benefit (Social Security Act § 1861(s)(8)). In order for a beneficiary’s nutrition to be eligible for reimbursement the reasonable and necessary (R&N) requirements set out in the National Coverage Determinations (NCD) Manual (CMS Pub. 100-03), Chapter 1, Section 180.2 must be met. In addition, there are specific regulatory, payment and coding requirements, discussed below, that also must be met.
Read the complete advisory article, Enteral Nutrition – Correct Coding and Billing.