B4187 — Omegaven, 10 grams lipids
B4187 is a HCPCS Level II code for omegaven, 10 grams lipids. It belongs to the Enteral and Parenteral Therapy section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of B4187 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 15 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for B4187
- Long descriptor
- Omegaven, 10 grams lipids
- Short descriptor
- Omegaven, 10 grams lipids
- Added
- January 1, 2020
- BETOS
- O1C
- Pricing indicator
- 39 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Parenteral and enteral nutrition.
Codes adjacent to B4187
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If B4187 is not quite right, the correct code is very often within a few positions of it.
- B4162Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit
- B4164Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix
- B4168Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix
- B4172Parenteral nutrition solution; amino acid, 5.5% through 7%, (500 ml = 1 unit) - home mix
- B4176Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix
- B4178Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix
- B4180Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix
- B4185Parenteral nutrition solution, not otherwise specified, 10 grams lipids
- B4189Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix
- B4193Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix
- B4197Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix
- B4199Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix
- B4216Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day
- B4220Parenteral nutrition supply kit; premix, per day
- B4222Parenteral nutrition supply kit; home mix, per day
- B4224Parenteral nutrition administration kit, per day
Questions about B4187
What is HCPCS code B4187?
B4187 is a HCPCS Level II code for omegaven, 10 grams lipids. It sits in the Enteral and Parenteral Therapy section.
Does Medicare cover B4187?
The CMS HCPCS file marks B4187 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.