Which diagnosis would meet Medicare Part B coverage criteria to qualify a beneficiary for home enteral nutrition?

• A. Aspiration pneumonia
• B. Dysphagia
• C. Anorexia
• D. Malnutrition

Answer: (B)

The main factor Medicare Part B looks for is a medical diagnosis that directly causes the patient to be unable to meet nutritional needs by mouth and thus requires long-term tube feeding with ongoing professional management. Dysphagia fits this as the condition that impairs swallowing and makes safe, adequate oral intake unlikely, creating a clear need for enteral nutrition at home.

While aspiration pneumonia can be a complication of dysphagia, it is not the underlying diagnosis that justifies home enteral nutrition coverage by itself. Anorexia and malnutrition describe low intake or poor nutritional status but do not, on their own, establish the medical reason for needing a feeding tube under Part B; there must be a specific condition—like dysphagia—that necessitates tube feeding for long-term support.