Article Detail - JA DME

It is important to know that enteral nutrition is covered when a beneficiary cannot adequately meet nutritional needs through oral consumption or oral supplementation. Oral intake of food for gratification purposes would not necessarily preclude the beneficiary from coverage for enteral nutrition. The medical records need to support the reason for oral intake. Enteral nutrition products and related supplies that are administered orally are noncovered, no benefit. If you are billing for products that are only administered orally, these should be coded as A9270.

Refer to the Noridian Medicare Enteral Nutrition webpage for additional resources.