## **What is HCPCS code B9002?**
HCPCS code B9002 refers to an enteral nutrition infusion pump, any type, used when enteral nutrition is administered through a feeding tube rather than orally. This device delivers enteral formula or special nutrient formulas at a controlled rate, ensuring the beneficiary receiving enteral nutrition gets the appropriate amount of nutrients. Unlike the gravity method, an enteral nutrition infusion pump provides precise delivery for patients who cannot rely on oral feedings or natural foods.
B9002 is the specific code for an enteral infusion pump; it is distinct from the daily enteral feeding supply allowances (B4034–B4036, B4148). Also, this is the only code that describes an enteral system involving a pump; it is not a miscellaneous code. Providers must use the specific code description for B9002 instead of reporting under a different code.
Correct coding ensures that the supply allowances, administration set tubing, in-line cartridge, and extension tubing related to the pump are billed properly as part of enteral nutrition services involving infusion.
## **HCPCS code B9002 documentation requirements**
When billing HCPCS code B9002, providers must carefully document all aspects of the enteral nutrition services involving the pump.
The beneficiary’s medical record should clearly show the medical necessity of the pump and why enteral nutrition administered via a feeding tube is required instead of oral feedings or natural foods.
### **Key documentation includes:**
- Treating practitioner’s order confirming the need for an enteral nutrition infusion pump and the specific enteral formula codes or special nutrient formulas prescribed.
- Clear notes describing whether the beneficiary is receiving enteral nutrition products through a gastrostomy tube site, secure tube, or in-line cartridge system.
- Justification that the pump provides medical benefit beyond the gravity method, such as using a gastric pressure relief valve, ensuring safe tube feedings, or delivering electrolyte-containing fluids.
- Evidence in the beneficiary’s nutrition records that the pump is medically necessary for the prosthetic device benefit under the Social Security Act.
- In addition, documentation should address any related supply allowances, such as administration set tubing, extension tubing, or related supplies, ensuring they align with correct coding and are not billed under a different code or miscellaneous code.
For compliance, providers should verify the specific code description, confirm the pump is not billed with two enteral nutrition products on a single claim line, and include all services reflecting medical necessity to avoid denials.
## **B9002 billing requirements**
Billing HCPCS Code B9002 requires careful attention to medical necessity, modifiers, and payer-specific rules. B9002 is not a miscellaneous/NOC code.
To establish medical necessity, providers must document why a gravity feeding setup is inadequate. This usually involves conditions such as reflux, aspiration, diarrhea, dumping syndrome, or blood glucose instability. Without this documentation, Medicare and other payers are likely to deny coverage.
When submitting claims, using the correct modifiers makes a significant difference. Use NU for a new purchase, RR if the pump is rented, and KX to confirm that coverage criteria are met. Medicare generally allows only one infusion pump per patient, but a replacement may be approved if the patient’s condition still justifies its use.
Finally, remember that claims should be filed through the DME MAC under Medicare Part B. Coverage applies whether the pump is used in a hospital, a home health setting, or a skilled nursing facility, as long as all medical and billing requirements are met.
## **Other related codes**
- B9004 – Parenteral nutrition infusion pump, portable
- B9006 – Parenteral nutrition infusion pump, stationary
Frequently asked questions
