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Parenteral therapy has two forms, peripheral parenteral nutrition (PPN) and total parenteral nutrition (TPN). The main difference between PPN and TPN is the route of delivery. PPN is delivered through a large-bore peripheral IV catheter; TPN requires a central venous catheter.
PPN is intended for short-term use or supplementation. In most instances, it is used to maintain a previously well-nourished, nonhypermetabolic patient or to serve as a bridge to centrally administered infusions or enteral feedings until more suitable nutrition can be provided.
TPN is CARBOHYDRATE based while PPN is FAT based. Central parenteral nutrition solutions usually contain about 1 kcal/ml and they usually provide about 55% to 60% of calories as carbohydrate (in the form of high concentration dextrose) and 15% to 20% of calories as protein.
Parenteral/Enteral Nutrition (PEN) Therapy Parenteral/enteral pumps are in their own DMEPOS Payment Category and are limited to payments for a total of 15 months during a period of medical need. Payment policies for these pumps generally follow the rules for capped rental items.
PPN will usually involve a more diluted formula with fewer calories and is only recommended for a short-term duration. In contrast, TPN is for long-term or even permanent duration, and will therefore use a denser, higher calorie formulation. These differences usually involve different methods of administration.
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A PPN is an information-sharing document that records safeguarding concerns about an adult or child. PPNs are shared with partner agencies to inform a multi-agency response.
Parenteral nutrition is covered for a beneficiary with permanent, severe pathology of the alimentary tract which does not allow absorption of sufficient nutrients to maintain weight and strength commensurate with the beneficiarys general condition.
TPN-dependent patients have a 3-year survival chance of about 65 to 80%, and for the 20 to 35% of patients who do not respond well to TPN, intestinal transplantation may be a life-saving option.

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