Tools and resources to help educate your insurer about severe food allergies and why you may qualify to get reimbursement. Remember, our Nutricia Navigator team can help you navigate the reimbursement landscape.
Claims for Reimbursement usually require use of Reimbursement and Healthcare Common Procedures Coding System (HCPCS) Codes:
“Reimbursement billing codes” are terms you will often hear referenced. The codes are part of a system created by insurance companies to identify the nutritional product or category and to process claims. Some states require by law that certain diagnoses must be subject to reimbursement. Your doctor’s office may have more information regarding reimbursement in your state.
- Neocate products are identified using HCPCS or Reimbursement Codes (see below).
- Most insurance plans and government programs recognize these reimbursement billing codes.
In addition, there are diagnosis billing codes, also called ICD-10 codes, that identify the disease of the patient and may be required when submitting for reimbursement.
By providing accurate coding and complete documentation, you greatly increase your chance for coverage and payment.
Reimbursement and HCPCS Codes
As we explained above, some insurance companies and state programs that cover our products require a reimbursement or Healthcare Common Procedure Code (HCPCS). We’ve listed these codes here for your convenience.
|Neocate® Syneo Infant||127049||49735-0114-36||B4161|
|Neocate® Junior Unflavored (without Prebiotics) Unflavored||127048||49735-0117-90||B4161 or B4153|
|Neocate® Junior Unflavored (with Prebiotics)||134054||49735-0129-12||B4161 or B4153|
|Neocate® Junior Vanilla||133282||49735-0106-27||B4161 or B4153|
|Neocate® Junior Strawberry||133280||49735-0164-56||B4161 or B4153|
|Neocate® Junior Tropical||133048||49735-0121-24||B4161 or B4153|
|Neocate® Junior Chocolate||133283||49735-0126-90||B4161 or B4153|
|Neocate® Splash Unflavored||111394||49735-0144-51||B4161 or B4153|
|Neocate® Splash Grape||122435||49735-0124-35||B4161 or B4153|
|Neocate® Splash Tropical Fruit||122437||49735-0124-37||B4161 or B4153|
|Neocate® Splash Orange-Pineapple||122436||49735-0124-36||B4161 or B4153|
Neocate® Splash Vanilla
|176678||49735-0100-59||B4161 or B4153|
Other Nutritional Products
|Essential Amino Acid Mix||53342||49735-0114-90||B4155|
|Complete Amino Acid Mix||53341||49735-0101-24||B4155|
*Nutricia North America does not represent these codes to be National Drug Codes (NDCs). NDC-format codes are product codes adjusted according to standard industry practice to meet the format requirements of pharmacy and health insurance systems.
Some insurance companies and state programs that cover our products require a diagnosis code from your doctor. Contact your healthcare professional for the ICD Codes for your GI and allergic conditions, and/or potential symptoms of these conditions.
Remember, our Nutricia Navigator team can help you make sense of this. Give them a call today at 1-800-365-7354.