S9435 Medical foods for inborn err
Also known as: metabolic formula, PKU formula, amino acid formula
Medical foods for inborn errors of metabolism are specialized enteral formulations with modified amino acid profiles or specific nutrient composition for genetic metabolic disorders.
In Plain Language
special food for genetic conditions
Clinical Context
Used for phenylketonuria (PKU), maple syrup urine disease (MSUD), tyrosinemia, and other inborn errors of metabolism. Specialized amino acid profile prevents metabolite accumulation.
RVU Information
CPT S9435 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.
Specialties
Frequently Asked Questions
What is CPT code S9435?
CPT S9435 (Medical foods for inborn err) is a S Codes code. Medical foods for inborn errors of metabolism are specialized enteral formulations with modified amino acid profiles or specific nutrient composition for genetic metabolic disorders.
Is S9435 covered by insurance?
S9435 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used for phenylketonuria (PKU), maple syrup urine disease (MSUD), tyrosinemia, and other inborn errors of metabolism. Specialized amino acid profile prevents metabolite accumulation.
When is CPT S9435 used?
Used for phenylketonuria (PKU), maple syrup urine disease (MSUD), tyrosinemia, and other inborn errors of metabolism. Specialized amino acid profile prevents metabolite accumulation.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.