Summary & Overview
HCPCS J0895: Injection, Deferoxamine Mesylate 500 mg
HCPCS Level II code J0895 denotes injection of deferoxamine mesylate, 500 mg, an iron-chelating medication used in conditions requiring removal of excess iron. Nationally, accurate coding for parenteral chelation therapy affects coverage determinations, billing consistency, and cost tracking for infusion services across outpatient settings. This code matters for hospitals, infusion centers, and physician practices that administer specialty injectable therapies.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for J0895, typical sites of service, and the role this code plays in billing for parenteral specialty drugs. The publication outlines benchmark considerations, common billing modifiers encountered for injectable drugs, and policy updates that influence prior authorization and coverage rules.
The report also summarizes operational implications for providers and billing teams, including documentation expectations and service-line alignment for infusion and outpatient administration. Data not available in the input is noted where specific payer reimbursement rates, utilization benchmarks, and associated taxonomies or ICD-10 mappings are missing.
Billing Code Overview
HCPCS Level II code J0895 represents an injection of deferoxamine mesylate, 500 mg. This code is used to bill for the therapeutic administration of the iron-chelating agent deferoxamine in a 500 mg dosage form.
Service type: Parenteral drug administration (intravenous or subcutaneous infusion/injection)
Typical site of service: Hospital outpatient departments, infusion centers, physician offices, and other outpatient care settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with documented iron overload (for example due to transfusion-dependent thalassemia, sickle cell disease, myelodysplastic syndrome, or chronic transfusion therapy) who requires parenteral chelation therapy. The patient presents to an outpatient infusion center or hospital outpatient department for administration of J0895 (Injection, deferoxamine mesylate, 500 mg). The clinical workflow includes: pre-infusion nursing assessment (vital signs, review of recent iron studies such as serum ferritin and transferrin saturation), verification of the prescription and dose (weight-based dosing or clinician-ordered regimen), medication preparation under sterile conditions, patient consent and allergy review, peripheral IV or existing central venous access assessment, infusion or subcutaneous slow infusion as ordered, monitoring for infusion reactions and local site reactions, documentation of lot number and units administered, and post-infusion discharge instructions. Typical sites of service are outpatient infusion centers, hospital outpatient departments, specialty hematology clinics with infusion capability, and occasionally skilled nursing facilities for home infusion support. Patient monitoring includes hearing and vision assessments periodically due to known toxicities, and coordination with the prescribing hematologist for ongoing chelation plan adjustments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used (placeholder) |