INJECTAFER

An intravenous iron replacement medication called Injectafer® (ferric carboxymaltose injection) is prescribed to treat iron deficiency anemia (IDA) in adult patients with chronic kidney disease that is not dependent on dialysis, intolerance to oral iron, or an inadequate response to oral iron. For proper reimbursement and compliance, accurate billing and coding are necessary. Here are several important rules:
HCPCS Code: J1439: Ferric carboxymaltose injection, 1 mg.
Billing Example: Since each unit is equivalent to 1 mg, bill 750 units for a 750 mg dose of Injectafer.
00517-0602-01: Injectafer 100 mg iron/2 mL single-use vial is the National Drug Code (NDC).
00517-0650-01: Single-use vial of Injectafer 750 mg iron/15 mL.

Administration Codes: Intravenous injections of injectafer are used. The administration may be eligible for the following CPT® codes:
96374: Intravenous push, single or first substance/drug; therapeutic, prophylactic, or diagnostic injection (specify substance or drug).
96365: Intravenous infusion for diagnosis, treatment, or prevention (name a medicine or substance); initial, up to 1 hour.

Diagnosis Codes: The patient's condition should be reflected in the appropriate ICD-10-CM diagnosis codes. The following are typical codes linked to injectafer therapy:
D50.0: Chronic iron deficiency anemia due to blood loss.
D50.8: Additional anemias caused by iron deficiency.
D50.9: Unspecified iron deficiency anemia.
N18.1: Stage 1 chronic renal disease.
N18.2: Stage 2 (mild) chronic renal disease.
N18.3: Stage 3 (moderate) chronic renal disease.
N18.4: Stage 4 (severe) chronic renal disease.
N18.5: Stage 5 chronic renal disease.
End-stage renal disease (N18.6).
N18.9: Unspecified chronic renal disease.
Note: The patient's particular clinical condition and supporting documents should be taken into consideration while choosing the right diagnosis code.

Extra Billing Considerations: Pre-Authorization: Prior authorization is required by many insurance plans for treatments such as Injectafer. Before starting treatment, make sure that all required approvals have been received.
Documentation: Keep thorough medical records that include the diagnosis, treatment plan, dosage, administration route, and specifics of the administration. This paperwork enables efficient claims processing and substantiates medical necessity.
Consult the manufacturer's Injectafer Billing and Coding Guide for complete and current information.
Following these recommendations will help ensure that Injectafer therapy is accurately billed and reimbursed.