Summary & Overview
HCPCS C9441: Injection, Ferric Carboxymaltose, 1 mg
HCPCS Level II code C9441 designates the injectable iron product ferric carboxymaltose billed per milligram. This code matters nationally as intravenous iron therapies are widely used to treat iron deficiency and anemia across outpatient infusion settings and hospital clinics. Coding at the per-milligram level affects billing granularity and reimbursement calculation for high-cost infusion therapies.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payment benchmarks and coverage considerations for IV iron therapy, clinical context for ferric carboxymaltose use, and related billing implications such as service lines and typical sites of care. The publication outlines common coding uses and what to expect in payer coverage patterns and claims adjudication nationally. Policy updates and coding guidance relevant to HCPCS Level II reporting practices are summarized to inform billing staff, revenue cycle managers, and policy analysts.
The content provides a concise reference for clinicians and administrators to understand how C9441 is applied in practice, where it is typically administered, and which major national payers are relevant to contracting and claims processes.
Billing Code Overview
HCPCS Level II code C9441 describes Injection, ferric carboxymaltose, 1 mg. This code represents the billed line item for administration of ferric carboxymaltose measured per milligram. The service type is an injectable iron therapy formulation intended for intravenous infusion. The typical site of service for this therapy is outpatient infusion centers, hospital outpatient departments, or other clinical settings equipped for intravenous administration.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with iron deficiency anemia who has intolerance to or inadequate response to oral iron therapy and is scheduled to receive intravenous ferric carboxymaltose. The patient presents to an outpatient infusion center or hospital outpatient department for treatment. The clinical workflow includes pre-infusion evaluation (vital signs, review of allergy history, confirmation of hemoglobin/iron studies), eligibility confirmation using diagnosis and laboratory results, informed consent, venous access placement, administration of C9441 dosed per milligram preparation (ordered by the provider), monitoring for infusion reactions during and for at least 30 minutes after infusion, documentation of lot number and dose administered, and discharge instructions for delayed adverse events. Typical sites of service are outpatient infusion centers, hospital outpatient departments, and physician offices equipped for parenteral iron administration. Common clinical scenarios include iron deficiency anemia due to chronic blood loss (e.g., menorrhagia, gastrointestinal bleeding), iron deficiency related to chronic kidney disease not on dialysis, or iron-restricted erythropoiesis in patients receiving erythropoiesis-stimulating agents.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure |