Produced by - Mead Johnson Nutrition

EXHIBIT 16 - ENTERAL PRODUCTS REFERENCE GUIDE: 1998 – 2002 MEDICARE IIC RATESHCPCS Item Special Instructions 1998 Part BCode AllowableB4034 Enteral feeding supply kit, syringe fed, per day (includes feeding ➝ May only use one type of enteral feeding kit per month $5.60syringes, tape with wipes) ➝ Kit must be consistent with method of administration➝ Kit contents usually include the contents listed, but not limited to listed items➝ If a pump supply kit is ordered and pump is not approved, will receive B4036 allowable➝ Payment based on per diem rate; report total number of actual days administered➝ Kit includes all items necessary for administration of enteral therapy➝ Patient will not be made accountable for additional items billed separatelyB4035 Enteral feeding supply kit, pump fed, per day (includes containers, $10.67syringes, tape with wipes)B4036 Enteral feeding supply kit, gravity fed, per day (includes gravity sets, $7.31containers, syringes, tape with wipes)B4081 Nasogastric (NG) tubing with stylet More than 3 nasogastric tubes every 3 months is rarely medically necessary $19.78(DMERC Region C allows 3 nasogastric tubes every month)B4082 Nasogastric (NG) tubing without stylet $14.73B4083 Stomach tube – Levine type $2.25B4084 Gastostomy/Jejunostomy tubing More than 1 gastostomy or jejunostomy tube every 3 months is rarely medically necessary $16.52(DMERC Region C allows 1 gastostomy or jejunostomy tube every month)B4085 Gastostomy/Jejunostomy tubing (silicone with sliding ring) $37.48B4150 Enteral formula, Category I, semi-synthetic intact protein/protein No additional documentation is required $0.61isolatesNote: Powdered Formulas are 100formulas require calories per unitmodifier DD Allowable(e.g., B4150DD) amounts are perone unitB4152 Enteral formula, Category II, semi-synthetic intact protein/protein Approved when medically necessary $0.51isolates, calorically denseB4153 Enteral formula, Category III, hydrolyzed protein/amino acids $1.74Additional documentation is required to supportmedical necessity for these formulas; if not properlysubstantiated, payment is made for Category I,B4150B4154 Enteral formula, Category IV, defined formula for special metabolic $1.12needsB4155 Enteral formula, Category V, modular components $0.87The above instructions and rates may be subject to change. Providers should consult with the applicable DMERC for applicable instructions and rates.69