Table of Contents Previous Next

December 2016 Texas Medicaid Provider Procedures Manual

Medical and Nursing Specialists, Physicians, and Physician Assistants Handbook : 9 Physician : 9.2 Services, Benefits, Limitations, and Prior Authorization : 9.2.39 Clinician-Administered Drugs : 9.2.39.25 Iron Injections

9.2.39.25
Iron is a hematinic, essential to the synthesis of hemoglobin to maintain oxygen transport and to the function and formation of other physiologically important heme and non-heme compounds.
Ferric carboxymaltose (procedure code J1439) may be indicated for, but is not limited to, treatment of iron deficiency anemia for adult clients with:
Iron Dextran injection (procedure code J1750) may be indicated for, but is not limited to treatment of Iron deficiency anemia when oral administration is unsatisfactory or impossible.
Iron Sucrose injection (procedure code J1756) may be indicated for, but is not limited to treatment of iron deficiency anemia for the following conditions:
Sodium Ferric Gluconate Complex injection (procedure code J2916) may be indicated for, but is not limited to treatment of Iron deficiency anemia in clients who are six years of age or older who are undergoing long term hemodialysis treatments and who are receiving supplemental epoetin therapy.
Ferumoxytol injection (procedure codes Q0138 and Q0139) may be indicated for, but is not limited to treatment of Iron deficiency anemia in adults who have chronic kidney disease (CKD).
Note:
Authorization is not required for iron injections. Retrospective review may be performed to ensure documentation supports the medical necessity for the service being billed.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.