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||111436||49735-0114-36||B4161|
|Neocate® Junior (Unflavored)||11790||49735-0117-90||B4161|
|Neocate® Junior with Prebiotics (Unflavored)||12912||49735-0129-12||B4161|
|Neocate® Junior with Prebiotics (Vanilla)||60627||49735-0106-27||B4161|
|Neocate® Junior with Prebiotics (Strawberry)||86456||49735-0164-56||B4161|
|Neocate® Junior (Tropical)||12124||49735-0121-24||B4161|
|Neocate® Junior (Chocolate)||12690||49735-0126-90||B4161|
|Neocate® Splash (Unflavored)||84451||49735-0144-51||B4161|
|Neocate® Splash (Grape)||122435||49735-0124-35||B4161|
|Neocate® Splash (Tropical Fruit)||122437||49735-0124-37||B4161|
|Neocate® Splash (Orange-Pineapple)||122436||49735-0124-36||B4161|
Other Nutritional Products
|Essential Amino Acid Mix||553342||49735-0114-90||B4155|
|Complete Amino Acid Mix||553341||49735-0101-24||B4155|
*US Reimbursement codes listed above have been submitted by Nutricia North America to US data warehouses based on the standard format. These codes are not NDC numbers.
Some insurance companies and state programs that cover our products require a diagnosis code from your doctor. Contact your health care professional or your ICD Codes. Remember, our Nutricia Navigator team can help you make sense of this. Give them a call today at 1-800-365-7354, Option 8.