Summary & Overview
HCPCS Level II B4176: Parenteral Amino Acid Solution, Home Mix
HCPCS Level II code B4176 designates a home-mix parenteral nutrition solution of amino acids in the 7%–8.5% concentration, billed per 500 ml unit. This code is used for the supply of amino-acid component solutions for patients receiving home parenteral nutrition (HPN), an essential therapy for individuals with intestinal failure or other conditions preventing adequate enteral intake. Nationally, accurate coding of parenteral nutrition components affects coverage, clinical continuity, and supply chain management for home infusion services.
Key payers in the scope of this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for amino-acid parenteral solutions, common sites of service, and what typical billing usage represents. The publication outlines how B4176 is applied in home infusion workflows, summarizes payer coverage landscape and common modifier usage where available, and highlights benchmarking and policy considerations relevant to supply, unitization (500 ml = 1 unit), and documentation.
The report is intended to inform coding, revenue cycle, and clinical operations teams about the role of B4176 in home parenteral nutrition billing and to provide clarity on the clinical product represented by the code. Data not available in the input is noted when specific payer policies, taxonomies, ICD-10 pairings, and related codes are not provided.
Billing Code Overview
HCPCS Level II code B4176 describes a parenteral nutrition solution consisting of amino acids, 7% through 8.5%, supplied as a home-mix formulation. The code specifies a unit of measure of 500 ml = 1 unit.
Service type: Parenteral nutrition (amino acid solution) preparation and supply for home infusion
Typical site of service: Home infusion / patient residence, with preparation occurring in a pharmacy or home infusion provider setting.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic intestinal failure or severe malabsorption who requires home parenteral nutrition (HPN) for long-term nutrition support. The patient is discharged from an acute care hospital after surgical resection of a portion of the small bowel for Crohn disease complications, or from oncology care with prolonged mucositis and inability to tolerate enteral intake. The home health infusion company coordinates supply delivery of compounded amino acid solution B4176 (7%–8.5% amino acid, 500 ml unit) as part of a multi-component parenteral nutrition regimen.
The clinical workflow: a physician documents the need for parenteral nutrition and an individualized prescription specifying solution composition, volume, rate, and frequency. A home infusion pharmacist compounds the B4176 amino acid component under sterile conditions and labels units (500 ml = 1 unit). A home infusion nurse trains the patient/caregiver on central venous catheter care, infusion pump operation, and troubleshooting. Orders for ancillary components (dextrose, lipid emulsion, electrolytes, micronutrients) and supplies (IV tubing, dressing kits) are placed. Nursing performs periodic home visits for vital signs, weight, laboratory monitoring (electrolytes, liver function tests, prealbumin), and documents tolerance and catheter site status. Claims for B4176 are submitted under HCPCS Level II with appropriate modifier(s) reflecting payer-specific circumstances (for example facility vs professional billing, or services requiring special handling).
Coding Specifications
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