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    v1.0.30
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j1437-ferric-derisomaltose-injection-10mg
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    HCPCS J1437: Ferric Derisomaltose Injection, 10 mg

    HCPCS Level II code J1437 describes an injection of ferric derisomaltose, 10 mg, used for intravenous iron therapy; the service is an intravenous medication administration typically delivered in outpatient infusion centers or hospital outpatient departments for treatment of iron deficiency when parenteral iron is indicated.

    For related coverage guidance, see recent payer policy updates: T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Tumor Treatment Fields - Medical Policy, Extracorporeal Photopheresis.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with iron-deficiency anemia who has failed or cannot tolerate oral iron therapy and is scheduled to receive an intravenous iron infusion of ferric derisomaltose (J1437). The patient is evaluated in an outpatient infusion suite or hospital outpatient infusion center. Pre-infusion workflow includes verification of diagnosis, baseline vital signs, informed consent, review of prior reactions to IV iron, and documentation of recent hemoglobin, ferritin, and transferrin saturation results. An IV line is placed, the calculated therapeutic dose is prepared by pharmacy (using J1437 billed per 10 mg increment), and the infusion is administered over the manufacturer-recommended infusion time while monitoring for hypersensitivity or infusion reactions. Post-infusion monitoring includes vital signs, observation for 15–60 minutes per institutional protocol, documentation of any adverse events, and discharge instructions. Typical sites of service are outpatient infusion centers, physician office-based infusion suites, or hospital outpatient departments.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipunctureOften performed prior to infusion for baseline hemoglobin, ferritin, and iron studies.
    96360Intravenous infusion, hydration; initial, 31 minutes to 1 hourMay be used for reporting if the infusion time and payer policy align with initial IV drug administration timing when no specific chemotherapy/biologic infusion code is reported.
    96361Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary service)When prolonged infusion monitoring or extended infusion time beyond the initial hour is documented.
    96365Intravenous infusion, therapeutic, prophylactic, or diagnostic; initial, up to 1 hourUsed for reporting administration of non-chemotherapy biological agents in some payer contexts when applicable.
    36416Collection of capillary blood specimenUsed when point-of-care capillary testing is performed for hemoglobin monitoring before or after infusion.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208D00000X
    207Q00000X
    207L00000X
    363LF0000X
    333600000X
    207PT0002X
    302F00000X
    2251X0800X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    C81.90Hodgkin lymphoma, unspecified, unspecified site
    C82.90Follicular lymphoma, unspecified, unspecified site
    D37.9Neoplasm of uncertain behavior of digestive organ, unspecified
    D46.9Myelodysplastic syndrome, unspecified
    D50.0Iron deficiency anemia secondary to blood loss (chronic)
    D50.8Other iron deficiency anemias
    D50.9Iron deficiency anemia, unspecified
    D56.9Thalassemia, unspecified
    D61.9Aplastic anemia, unspecified
    D63.0Anemia in neoplastic disease

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and RomidepsinMass General Brigham Health Plan2027-01-04
    Tumor Treatment Fields - Medical PolicyHealth-New-England2026-12-01
    Extracorporeal PhotopheresisCigna2026-11-15
    Electric Tumor Treatment Field Therapy (for Tennessee Only)Colorado Rocky Mountain Health Plans2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    OmisirgeCigna2026-11-01
    Hematology - AdzynmaCigna2026-10-15
    Transcatheter Arterial Chemoembolization for Liver Tumorspremerabluecrossofwashington2026-10-01
    Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bonepremerabluecrossofwashington2026-10-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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