HCPCS Code B9998: NOC for Enteral Supplies

Learn how to bill HCPCS code B9998 for enteral nutrition supplies. Get documentation, billing requirements, and coverage details.

Use Code

## **What is HCPCS code B998?** HCPCS code B9998 is used as a miscellaneous code for "not otherwise classified (NOC) enteral supplies." This code applies when enteral nutrition products, supply allowances, or related items are provided to a beneficiary receiving enteral nutrition but don't fall under a specifically denied enteral formula code or supply code. This code ensures that when a patient requires enteral nutrition administered via a feeding tube, such as a gastrostomy tube site or gravity method, the associated enteral nutrition products and related supplies can be reported, even if no specific code exists. Since B9998 is a miscellaneous code, payers, including Medicare and Medicaid services, typically require written coding verification review or an initial claim submission with supporting clinical details before reimbursement is considered.

## **HCPCS code B9998 documentation requirements** Because it is a unique HCPCS code, B9998 requires detailed documentation to support medical necessity. These records should clearly establish why the supply is essential for the beneficiary receiving enteral nutrition. B9998 is often used when billing enteral nutrition services involving supplies that don’t fall under other specifically defined enteral feeding supply allowances. Items like administration set tubing, extension tubing, and gastric pressure relief valves are already bundled under supply allowance codes (B4034, B4035, B4036, B4148) and cannot be billed separately with B9998. Since these items cannot be linked to another enteral formula code or supply allowance, proper documentation ensures correct coding and supports claim approval.

## **B9998 billing requirements** When billing HCPCS Code B9998, make sure you follow these payer-specific guidelines to ensure proper reimbursement: ### **Use only when no specific code applies** According to CMS guidance, B9998 is strictly for enteral supplies not covered by other specific codes, such as B4034–B4036 or B4105. Claims that include items already described by those codes should not use B9998 (Article - Enteral Nutrition - Policy Article (A58833), n.d.). ### **Manual pricing may apply** Some payers, such as state Medicaid programs (e.g., KMAP), require prior authorization and manual pricing, which is calculated as the provider's cost plus a percentage, rather than a standard fee schedule (Connecticut Medical Assistance Program (CMAP), 2024). ### **Standard Written Order (SWO)** Medicare and most payers require a signed SWO (or Written Order Prior to Delivery) before items are dispensed. A claim submitted without this documentation will be denied as not reasonable and necessary. The SWO must include: - Beneficiary’s name or Medicare ID - Date of the order - Detailed description of the item(s) - Quantity to be dispensed - Prescriber’s name, signature, and date ### **Medical necessity documentation** Supplier records must also include practitioner notes and the beneficiary’s medical record showing why the supply is essential and not covered under existing supply allowances. Documentation must be kept on file, even if not submitted with the claim.

## **Other releted codes** - B4034–B4036 – Enteral feeding supply kits (pump, gravity, and syringe).

Frequently asked questions

Yes, but only if there is no existing HCPCS code and the item is not already included in the daily enteral feeding supply allowances (B4034–B4036, B4148). If a specific code or allowance applies, B9998 cannot be used.

Not always. Requirements vary by payer, but obtaining prior authorization in addition to clear documentation is strongly recommended to help avoid denials.

No. B9998 cannot be used for experimental or investigational devices. Supplies must be medically necessary and recognized as standard care to qualify for coverage.