Summary & Overview
HCPCS B4102: Adult Enteral Fluid and Electrolyte Replacement Formula, 500 ml unit
HCPCS Level II code B4102 identifies an enteral formula intended for adults to replace fluids and electrolytes (clear-liquid type), with billing measured in 500 ml units. This code matters nationally because enteral fluid replacement is a common supportive therapy across acute, post-acute, and long-term care settings and can affect facility supply costs, clinical nutrition protocols, and coverage determinations.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of this formula, the typical service settings where B4102 is billed, and what to expect in payer coverage patterns. The publication summarizes reimbursement and billing benchmarks, common modifier usage, and administrative considerations relevant to enteral nutrition product billing.
The report is organized to help revenue cycle teams, clinical nutrition managers, and policy analysts quickly locate benchmarks, documentation expectations, and payer-specific coverage notes. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code B4102 describes an enteral formula for adults used to replace fluids and electrolytes (e.g., clear liquids). The billing unit is 500 ml = 1 unit.
Service type: Enteral fluid and electrolyte replacement formula
Typical site of service: Hospital inpatient, skilled nursing facility, long-term care, outpatient infusion clinic, or any setting where enteral fluid replacement is administered
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult hospitalized for acute dehydration from viral gastroenteritis, postoperative ileus, or fluid-restricted oral intake who requires enteral replacement of fluids and electrolytes but can tolerate an oral or enteral clear-liquid formula. The order originates from the admitting physician or hospitalist; nursing obtains the enteral formula from pharmacy or central supply and documents administration volumes in the medication administration record. Billing uses B4102 with units calculated per 500 mL; for example, a 1,000 mL supply equals two units. Care team members involved commonly include the ordering physician, bedside nurse, registered dietitian (for electrolyte/volume assessment), and pharmacy for stocking and verification. Documentation should include the indication (e.g., dehydration, short-term oral intake intolerance), volume administered, start and stop dates/times, and any intolerance or adverse reaction notes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Procedure or service with no modifier | Use when no modifier is required or applicable |
22 |