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    OpenPayerBilling CodesEnteral and Parenteral TherapyHCPCS hcpcs-b4103-pediatric-enteral-fluid-replacement
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    HCPCS Level II B4103: Pediatric Enteral Formula for Fluid/Electrolyte Replacement

    HCPCS Level II code B4103 describes an enteral formula for pediatrics intended to replace fluids and electrolytes (clear-liquid type), with billing units defined as 500 mL per unit; the service type is enteral nutrition/medical nutrition therapy and the typical site of service is outpatient settings or facilities where pediatric enteral feeding or fluid replacement is administered (including clinics, outpatient infusion centers, and home health when applicable).

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Clinical & Coding Specifications

    Clinical Context

    A pediatric patient with acute gastroenteritis presents to an outpatient infusion center or emergency department exhibiting dehydration but able to tolerate enteral intake. The clinician orders a pediatric enteral electrolyte formula to replace fluids and electrolytes as clear liquids. Nursing verifies the enteral formula B4103 is age- and volume-appropriate, documents intake and tolerance, and administers measured 500 mL units orally or via feeding tube. Typical workflow: triage assessment → provider orders B4103 with units based on volume (one unit = 500 mL) → pharmacy or supply dispenses enteral formula → nursing administers and monitors vital signs, stool output, and electrolyte balance → disposition: discharge with oral rehydration instructions or admission if ongoing resuscitation is required.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96360Intravenous hydration, initial hourMay be billed when IV fluids are used instead of enteral formula for rehydration in the same episode.
    36415Collection of venous blood by venipunctureCommonly performed to obtain electrolytes and basic metabolic panel before or after rehydration with B4103.
    94640Pressurized or non-pressurized inhalation treatment for acute airway obstructionNot directly related but often performed in the ED for pediatric patients with concurrent respiratory distress; included here as an example of co-occuring ED procedures.
    43760Tube placement, nasojejunal or nasogastric for feedingPerformed when enteral formula B4103 must be delivered via a feeding tube rather than orally.
    96361Intravenous hydration, each additional hourRelated when prolonged IV hydration is required in conjunction with or instead of enteral replacement.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    363A00000X
    207L00000X
    207K00000X
    251C00000X
    273R00000X
    163WS0200X
    111NX0100X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 2

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    HCPCS-B4034-ENTERAL-FEEDING-SYRINGE-FED-DAILY-KIT

    HCPCS Level II B4034: Enteral Feeding Supply Kit, Syringe-Fed Per Day

    HCPCS-B4035-ENTERAL-FEEDING-SUPPLY-KIT-PUMP-FED-PER-DAY

    HCPCS Level II B4035: Enteral Feeding Supply Kit, Pump-Fed, Per Day

    HCPCS-B4036-ENTERAL-FEEDING-SUPPLY-KIT-GRAVITY-FED-DAILY

    HCPCS Level II B4036: Enteral Feeding Supply Kit, Gravity-Fed, Per Day

    HCPCS-B4081-NASOGASTRIC-TUBING-WITH-STYLET

    HCPCS Level II B4081: Nasogastric Tubing With Stylet

    HCPCS-B4082-NASOGASTRIC-TUBING-WITHOUT-STYLET

    HCPCS Level II B4082: Nasogastric Tubing Without Stylet

    HCPCS-B4083-LEVINE-STOMACH-TUBE-NASOGASTRIC-SUPPLY

    HCPCS Level II B4083: Levine Stomach Tube

    HCPCS-B4087-GASTROSTOMY-JEJUNOSTOMY-TUBE-STANDARD

    HCPCS Level II B4087: Gastrostomy/Jejunostomy Feeding Tube, Standard

    HCPCS-B4088-LOW-PROFILE-GASTROSTOMY-JEJUNOSTOMY-TUBE

    HCPCS Level II B4088: Low-Profile Gastrostomy/Jejunostomy Tube

    HCPCS-B4100-FOOD-THICKENER-ORAL-PER-OUNCE

    HCPCS Level II B4100: Food Thickener, Oral, Per Ounce

    HCPCS-B4102-ENTERAL-FLUID-ELECTROLYTE-REPLACEMENT-FORMULA-ADULT

    HCPCS Level II B4102: Enteral Formula for Fluid and Electrolyte Replacement

    Showing 1–10 of 50

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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