Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem
HCPCS code
Name of the Procedure:
Home Therapy: Enteral Nutrition via Pump
Common names: Home enteral nutrition, tube feeding at home
Technical/medical term: Enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (HCPCS Code: S9342)
Summary
Home therapy for enteral nutrition via pump is a treatment where patients receive necessary nutrients through a tube that goes directly into their stomach or small intestine. This method uses a special pump to ensure the patient gets the right amount of nutrition. It can be administered at home, which can be more convenient and comfortable for many patients.
Purpose
Medical Conditions Addressed:
- Severe swallowing disorders
- Chronic conditions that impair nutrient absorption
- Critical illness recovery
- Cancer or treatment-related malnutrition ##### Goals:
- Ensure adequate nutrition
- Improve or maintain body weight
- Enhance overall health and energy levels
- Minimize hospital visits and improve quality of life
Indications
- Patients with conditions like esophageal cancer or neurological disorders causing severe dysphagia.
- Individuals needing long-term nutritional support due to gastrointestinal diseases.
- Patients who have trouble eating and drinking enough to meet their nutritional needs.
Preparation
- Pre-Procedure Instructions: Clean the area around the feeding tube daily, follow instructions for tube flushing to prevent blockages.
- Diagnostic Tests: Nutritional assessments, blood tests, possibly imaging studies to confirm tube placement.
Procedure Description
- Initial Setup: The healthcare provider will install the feeding tube if not already in place.
- Connecting Equipment: Connect the feeding pump to the feeding tube.
- Programming the Pump: Set the pump according to a prescribed feeding schedule and flow rate.
- Administering Nutrition: The pump delivers the enteral formula at a controlled rate.
- Monitoring: Regularly check tube placement, skin condition around the entry site, and monitor for any signs of discomfort or complication.
Tools and Equipment:
- Enteral feeding pump
- Feeding tube
- Enteral formula
- Associated supplies (syringes, cleaning agents)
Anesthesia or Sedation:
- Typically not required for the feeding process, but may be used during initial tube placement.
Duration
The actual feeding process via pump can take several hours per day, depending on the prescribed feeding regimen. Setup and monitoring can be relatively quick, around 15-30 minutes daily.
Setting
Performed at the patient’s home, with initial setup and periodic check-ins by healthcare professionals.
Personnel
- Healthcare providers involved may include:
- Home health nurses
- Dietitians or nutritionists
- Pharmacists
- Physicians for overseeing the care plan
Risks and Complications
- Common Risks: Tube displacement, clogging or blockage of the tube, infection at the insertion site.
- Rare Risks: Aspiration pneumonia, metabolic complications, severe infections.
- Management: Regular tube maintenance, proper hygiene, monitoring for signs of infection or complications, prompt medical intervention when issues arise.
Benefits
- Expected Benefits: Improved nutritional status, better energy levels, enhanced overall health.
- Timeframe: Benefits can be seen within a few weeks, depending on the individual's condition and adherence to the feeding regimen.
Recovery
Post-Procedure Care:
- Regular cleaning and maintenance of the feeding site.
- Monitoring nutrition status with healthcare providers. ##### Recovery Time:
- Ongoing use for chronic conditions.
- Regular follow-up appointments for adjustments and assessments.
Alternatives
- Alternative Options: Oral nutritional supplements, parenteral (IV) nutrition.
- Pros and Cons:
- Oral Supplements: Less invasive but may not be sufficient for severe cases.
- Parenteral Nutrition: Appropriate for those unable to digest or absorb nutrients, but requires more complex and sterile care.
Patient Experience
During Procedure:
- Mild discomfort during initial setup, which typically resolves. ##### After Procedure:
- Most patients adapt well to home enteral feeding.
- Possible minor discomfort or irritation around the feeding tube site. ##### Pain Management:
- Local care to prevent infection and discomfort.
- Over-the-counter pain relievers if needed, under healthcare provider guidance.