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    OpenPayerBilling CodesEnteral and Parenteral TherapyHCPCS hcpcs-b4105-enteral-feeding-digestive-enzyme-cartridge
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    HCPCS B4105: In-line Digestive Enzyme Cartridge for Enteral Feeding

    HCPCS Level II code B4105 describes an in-line cartridge containing digestive enzyme(s) for enteral feeding, used as a medical supply component in enteral nutrition therapy; service type: enteral enzyme administration via cartridge for tube-fed patients; typical site of service: outpatient clinics, long-term care facilities, or home enteral nutrition settings where enteral feeding systems are managed.

    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 typical patient is an adult or pediatric patient receiving long-term or short-term enteral tube feeding who requires supplemental digestive enzymes to aid digestion and absorption due to exocrine pancreatic insufficiency, post-pancreatectomy state, or poor tolerance of enteral formula. The in-line enzyme B4105 is dispensed as a cartridge placed into the feeding set or enteral pump cartridge system and delivers digestive enzymes directly into the enteral feeding line during continuous or bolus tube feeds.

    A common clinical workflow: a gastroenterology or nutrition support clinician documents the indication (for example, malabsorption due to pancreatic insufficiency). An enteral nutrition order is written specifying the need for in-line enteral enzymes. Pharmacy or a home infusion/enteral supplier dispenses the B4105 cartridge. At bedside or in the home, nursing or trained caregivers attach the cartridge to the feeding tubing per manufacturer instructions, confirm pump settings for feed rate, monitor tolerance (abdominal pain, bloating, stool output), and document use in the medical record. Reorders occur based on ongoing clinical need and payer authorizations.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    43246Endoscopic placement of feeding tube, percutaneous, without imaging guidancePerformed when enteral access must be established or revised before ongoing use of an in-line enzyme cartridge.
    49440Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), when performed, and image documentationAlternative method of establishing long-term enteral access prior to initiation of enteral enzyme therapy.
    96360Hydration, initial, intravenous, up to 1 hourMay be billed if IV therapy is provided for dehydration in patients with malabsorption undergoing initiation of enteral enzyme therapy.
    94660Continuous positive airway pressure ventilation via mask; initiation and managementIncluded as a supportive therapy example in medically complex patients receiving enteral nutrition; billed when applicable.
    99406Smoking and tobacco-use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutesExample of a counseling service that may be provided during nutrition management visits; billed when performed.

    Related Modifiers

    5 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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    363A00000X
    363L00000X
    332U00000X
    261QU0200X
    2086H0002X
    111NX0800X
    305R00000X
    363AM0700X

    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
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar 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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