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    v1.0.30
    OpenPayerBilling CodesEnteral and Parenteral TherapyHCPCS hcpcs-b5100-parenteral-nutrition-hepatic-hepatamine-premix
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    HCPCS Level II B5100: Parenteral Nutrition Hepatic Amino Acid/Carbohydrate Solution

    HCPCS Level II code B5100 describes a compounded parenteral nutrition solution containing amino acids and carbohydrates with electrolytes, trace elements, and vitamins formulated for hepatic support (hepatamine-premix); service type is compounded parenteral nutrition/total parenteral nutrition admixture preparation, typically provided in inpatient hospital and infusion clinic or home infusion settings where sterile compounding and IV administration occur.

    For related coverage guidance, see recent payer policy updates: Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical Policy, Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interaction.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old hospitalized patient with chronic liver disease and severe malnutrition is unable to tolerate enteral feeding due to persistent vomiting and gastroparesis. The attending hepatologist and nutrition support team order parenteral nutrition tailored to hepatic concerns using an amino acid and carbohydrate solution with electrolytes, trace elements, and vitamins, prepared as a hepatamine-premix formulation. Pharmacy compounds the sterile parenteral nutrition (PN) bag under USP <797> conditions, labels it, documents lot numbers and additives, and coordinates bedside administration via the patient’s existing central venous catheter. Nursing performs line access and pump programming, monitors glucose, electrolytes, fluid status, and liver function tests, and documents intake/output and tolerance. The interdisciplinary team reviews daily PN goals, adjusts electrolytes, trace elements, and vitamin dosing based on labs, and discontinues PN when enteral nutrition is feasible or metabolic goals are met.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipunctureUsed before or during PN therapy for baseline and ongoing laboratory monitoring of electrolytes, glucose, and liver function.
    36416Collection of capillary blood specimen (eg, finger, heel)Point-of-care glucose monitoring frequently performed during PN infusion to adjust dextrose delivery.
    36556Insertion of non-tunneled centrally inserted central venous catheter; without subcutaneous port or pump, age 5 years or olderMay be performed prior to PN initiation when central vascular access is required for hypertonic PN solutions.
    36561Exchange of peripherally inserted central venous catheter (PICC), age 5 years or olderUsed when existing PICC requires replacement or exchange related to PN administration issues.
    99406Smoking and tobacco use cessation counseling visit, intermediateExample of counseling codes sometimes billed by providers managing comorbidities; not directly related to PN compounding but common in inpatient care — include only if counseling provided per payer rules.
    96360Intravenous infusion, hydration; initial, 31 minutes to 1 hourUsed for co-administered IV fluids or short infusions alongside PN in certain clinical workflows; selection depends on payer and setting.

    Related Modifiers

    7 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…
    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
    207RH0000X
    208000000X
    364S00000X
    363L00000X
    246Q00000X
    2084P0804X
    261QR0405X
    246YC3302X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    A09Infectious gastroenteritis and colitis, unspecified
    B15.9Hepatitis A without hepatic coma
    C78.6Secondary malignant neoplasm of retroperitoneum and peritoneum
    C78.7Secondary malignant neoplasm of liver and intrahepatic bile duct
    E40Kwashiorkor
    E43Unspecified severe protein-calorie malnutrition
    E46Unspecified protein-calorie malnutrition
    E83.42Hypomagnesemia
    E87.1Hypo-osmolality and hyponatremia
    K52.9Noninfective gastroenteritis and colitis, unspecified

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 2

    10 rows

    PolicyPayerEffective Date
    Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical PolicyHealth-New-England2027-02-01
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Percutaneous electrical nerve field stimulation for disorders of gut-brain interactionpremerabluecrossofwashington2026-11-06
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    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

    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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