HCPCS code B4160: Enteral formula, for pediatrics, administered through an enteral feeding tube, 100 calories

B4160 is for a calorically dense pediatric formula (≥0.7 kcal/mL), meaning it provides more energy per volume. B4158 is for a standard nutritionally complete pediatric formula. B4160 is typically used when a patient cannot tolerate a large volume of formula but requires a high caloric intake.

No. This code is specifically designated for pediatric patients. The corresponding adult code for a calorically dense formula is B4152.

While many payers do require prior authorization, especially for specialized codes, it's not universal. You should always confirm the specific policy with the patient's insurance provider before billing to avoid denials.