S9367 — Home infusion therapy, total parenteral nutrition (tpn); more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment including standard tpn formula (lipids, specialty amino acid formulas, drugs other than in standard formula and nursing visits coded separately), per diem
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- For adults: documentation of involuntary weight loss of 10% in six months or 5% in one month (baseline weight and timeframe).
- For children: documentation of weight-for-length/height or sex percentile < 10th, inadequate weight gain, or significant decrease in usual growth percentile (growth charts/measurements).