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Reimbursement Codes





CONTACT PATHWAY FOR SPECIFIC RESOURCES AND SERVICES




1-800-558-7677

Monday through Friday,

8:30 AM to 5 PM, EST

GO TO THE PATHWAY SERVICES REQUEST FORMS




Reimbursement Codes

Codes are required by payers to identify the nutritional product or category of products. Abbott Nutrition products have HCPCS codes and NDC-format codes.

HCPCS Codes

The Healthcare Common Procedural Coding System (HCPCS) codes are utilized by Medicare, many of the state Medicaid programs, and commercial payers for billing purposes. HCPCS codes are assigned to nutritional products based on the ingredient and nutrient profiles as well as the intended use of the product. Many payers assign a rate to a HCPCS code which is often based on a billing unit of 100 calories.

NDC-format Codes

NDC-format codes are product codes adjusted according to standard industry practice to meet the format requirements of pharmacy and health insurance computer systems. Abbott Nutrition does not represent these products to be drugs, nor their codes to be NDC codes. Additionally, NDC-format codes listed have been submitted by Abbott Nutrition to a data warehouse. While Abbott Nutrition cannot confirm the NDC format codes have been published, the codes listed are based on the formatting established by data warehouses.

ICD-9 and ICD-10 Codes

In addition, many payers require diagnoses codes, also called ICD-9 or ICD-10 codes. These codes help identify the disease of the patient and some payers cover nutritional products for certain diagnoses. You can access commonly used ICD-9 codes for certain Abbott Nutrition products below.






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HMEs, DMEs and Pharmacies


PATHWAY can provide published codes and reimbursement information including HCPCS codes and NDC-format codes for Abbott Nutrition products. You can access this information below or contact PATHWAY directly at 1-800-558-7677 (Monday – Friday, 8:30am-5:00pm EST) to obtain it.





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ACCESS COMMONLY USED BILLING CODES AND ITEM DESCRIPTIONS FOR ABBOTT NUTRITION PRODUCTS


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(PDF 289Kb)




YOU CAN ALSO GET THE CODING AND BILLING INFORMATION YOU NEED HERE: