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HCPCS Q0138: Ferumoxytol Injection for Iron Deficiency Anemia, Non-ESRD

HCPCS Level II code Q0138 denotes an intravenous injection of ferumoxytol for the treatment of iron deficiency anemia in patients not receiving dialysis. As a parenteral iron replacement option, ferumoxytol has national clinical relevance for outpatient infusion services and specialty clinics treating iron-deficient patients who cannot tolerate or do not respond to oral iron.

Key payers referenced in standard coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for ferumoxytol use, typical sites of service, common billing modifiers, and payer coverage considerations where available. The publication outlines benchmarks and patterns relevant to utilization and reimbursement coding for non-ESRD ferumoxytol injections, highlights any recent policy or coverage updates when present, and summarizes coding best practices for accurate claim submission.

This analysis is intended for a national audience of clinicians, coding professionals, and revenue-cycle stakeholders seeking a clear summary of HCPCS Level II code Q0138, its clinical application, and the payer landscape for non-ESRD iron therapy in outpatient infusion settings.

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Billing Code Overview

HCPCS Level II code Q0138 describes an injection of ferumoxytol for the treatment of iron deficiency anemia, dosed at 1 mg per unit and specified for non-ESRD use. This service is a parenteral iron therapy administered intravenously for patients with iron deficiency anemia who are not on end-stage renal disease (ESRD) dialysis.

Service Type: Therapeutic infusion/injection (iron replacement therapy)

Typical Site of Service: Outpatient infusion center, hospital outpatient department, or clinic-based infusion setting

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HCPCS Q0138: Ferumoxytol Injection for Iron Deficiency Anemia, Non-ESRD

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Billing Code Overview

Service Type: Therapeutic infusion/injection (iron replacement therapy)

Typical Site of Service: Outpatient infusion center, hospital outpatient department, or clinic-based infusion setting

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with symptomatic iron deficiency anemia who has intolerance or inadequate response to oral iron therapy. The patient is referred to an infusion center by a hematologist or primary care provider after lab confirmation of low hemoglobin and low ferritin or transferrin saturation. Prior to administration of Q0138 (ferumoxytol injection, 1 mg unit), medication reconciliation, informed consent, allergy review, and baseline vital signs are documented. Intravenous access is established and the dose is prepared per product labeling. The patient receives the infusion in an outpatient infusion suite, ambulatory surgery center, or hospital outpatient department with monitoring for infusion reactions for at least 30 minutes after completion. Nursing documents lot number, volume administered, and any immediate adverse reactions. Post-infusion orders include follow-up labs (complete blood count, ferritin, iron studies) in 4–8 weeks and clinical reassessment by the ordering provider. Billing for Q0138 is per milligram; documentation must support the total milligrams administered and clinically appropriate use (non-ESRD iron deficiency anemia).

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug amount discarded/not administered	When a single-use vial contained excess ferumoxytol that was discarded and documentation of discarded amount is required
`JZ`	No drug or biological was wasted	When the exact amount drawn equals the billed amount with no waste
`QX`	CRNA service: CRNA with medical direction by physician	When a certified registered nurse anesthetist provides anesthesia services during the infusion procedure and medical direction applies
`QY`	CRNA service: medical direction of one CRNA by an anesthesiologist	When an anesthesiologist directly supervises a CRNA during the procedure
`RT`	Right side	If laterality reporting is required for any associated procedural code in the same encounter (not typically used for `Q0138` itself)
`78`	Unplanned return to operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	If the patient requires an urgent repeat procedure related to complications occurring during the same global period
`80`	Assistant surgeon	When an assistant surgeon performs a portion of a related procedural service (applies to surgical procedures paired with infusion when applicable)
`62`	Two surgeons	When two surgeons work together as primary surgeons on a related operative procedure in the same encounter
`52`	Reduced services	When the ferumoxytol infusion service was partially reduced or not performed as originally planned
`53`	Discontinued procedure	When the infusion was initiated but discontinued due to patient intolerance or reaction
`22`	Increased procedural services	When a documented substantial additional work or risk occurred beyond the typical infusion (e.g., management of severe infusion reaction)
`23`	Unusual anesthesia	When general anesthesia was required unexpectedly for the procedure in conjunction with the infusion
`JA`	Used when pharmacy billed amount differs (not standard CMS but payer-specific)	When payer requires reporting of specific pharmacy or billing circumstance related to administered drug

Taxonomy Code	Specialty	Notes
`208000000X`	Hematology	Hematologists commonly order and manage IV iron therapy for iron deficiency anemia
`207Q00000X`	Allergy/Immunology	Allergists may evaluate infusion reactions and manage premedication strategies
`363L00000X`	Infusion Therapy	Infusion nurses and centers administer IV ferumoxytol and manage monitoring
`207R00000X`	Family Medicine	Primary care providers often initiate evaluation and referral for IV iron
`207L00000X`	Internal Medicine	Internists manage chronic anemia and coordinate IV iron therapy

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D50.9`	Iron deficiency anemia, unspecified	Most common diagnosis indicating need for iron replacement when oral therapy is insufficient or not tolerated
`D50.0`	Iron deficiency anemia secondary to blood loss (chronic)	Indicates chronic blood loss as the etiology prompting IV iron therapy
`D50.8`	Other nutritional iron deficiency anemia	Used when iron deficiency is nutritional but requires parenteral therapy
`D63.8`	Anemia in other chronic diseases classified elsewhere	Used when iron deficiency anemia occurs with chronic inflammatory conditions and oral iron is ineffective
`N92.0`	Excessive and frequent menstruation with regular cycle	A common cause of iron deficiency anemia in women leading to IV iron use

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	May be used for billing infusion administration time when facility or payer requires a chemo/infusion administration CPT for IV iron infusions in outpatient settings
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Commonly used to report infusion administration services for therapeutic IV infusions like ferumoxytol when payer policies permit
`36415`	Collection of venous blood by venipuncture	Used for pre- and post-infusion laboratory draws (CBC, ferritin, iron studies)
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for the ordering provider visit or follow-up visit related to iron therapy management
`95115`	Professional services for allergen immunotherapy not related to ferumoxytol (placeholder)	Data not available in the input.

HCPCS Level II Q4139: Injectable Amniomatrix or Biodmatrix, 1 cc

HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

HCPCS Level II Q4256: Area-Based Procedural Add-On, Per sq cm

HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

HCPCS Level II Q5132: Adalimumab-afzb (Abrilada) 10 mg Injection

HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

HCPCS Q0035: Cardiokymography, Cardiac Motion Recording

HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

HCPCS Q0081: Infusion Therapy, Non-Chemotherapeutic, Per Visit

HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

HCPCS Q0083: Chemotherapy Administration, Non-Infusion

HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

HCPCS Q0085: Chemotherapy Administration, Infusion Plus Other Technique(s) per Visit

HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

HCPCS Q0091: Screening Pap Smear Specimen Collection and Transport

HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

HCPCS Q0092: Set-up of Portable X-Ray Equipment

Showing 1–10 of 629

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug amount discarded/not administered	When a single-use vial contained excess ferumoxytol that was discarded and documentation of discarded amount is required
`JZ`	No drug or biological was wasted	When the exact amount drawn equals the billed amount with no waste
`QX`	CRNA service: CRNA with medical direction by physician	When a certified registered nurse anesthetist provides anesthesia services during the infusion procedure and medical direction applies
`QY`	CRNA service: medical direction of one CRNA by an anesthesiologist	When an anesthesiologist directly supervises a CRNA during the procedure
`RT`	Right side	If laterality reporting is required for any associated procedural code in the same encounter (not typically used for `Q0138` itself)
`78`	Unplanned return to operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	If the patient requires an urgent repeat procedure related to complications occurring during the same global period
`80`	Assistant surgeon	When an assistant surgeon performs a portion of a related procedural service (applies to surgical procedures paired with infusion when applicable)
`62`	Two surgeons	When two surgeons work together as primary surgeons on a related operative procedure in the same encounter
`52`	Reduced services	When the ferumoxytol infusion service was partially reduced or not performed as originally planned
`53`	Discontinued procedure	When the infusion was initiated but discontinued due to patient intolerance or reaction
`22`	Increased procedural services	When a documented substantial additional work or risk occurred beyond the typical infusion (e.g., management of severe infusion reaction)
`23`	Unusual anesthesia	When general anesthesia was required unexpectedly for the procedure in conjunction with the infusion
`JA`	Used when pharmacy billed amount differs (not standard CMS but payer-specific)	When payer requires reporting of specific pharmacy or billing circumstance related to administered drug

Taxonomy Code	Specialty	Notes
`208000000X`	Hematology	Hematologists commonly order and manage IV iron therapy for iron deficiency anemia
`207Q00000X`	Allergy/Immunology	Allergists may evaluate infusion reactions and manage premedication strategies
`363L00000X`	Infusion Therapy	Infusion nurses and centers administer IV ferumoxytol and manage monitoring
`207R00000X`	Family Medicine	Primary care providers often initiate evaluation and referral for IV iron
`207L00000X`	Internal Medicine	Internists manage chronic anemia and coordinate IV iron therapy

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D50.9`	Iron deficiency anemia, unspecified	Most common diagnosis indicating need for iron replacement when oral therapy is insufficient or not tolerated
`D50.0`	Iron deficiency anemia secondary to blood loss (chronic)	Indicates chronic blood loss as the etiology prompting IV iron therapy
`D50.8`	Other nutritional iron deficiency anemia	Used when iron deficiency is nutritional but requires parenteral therapy
`D63.8`	Anemia in other chronic diseases classified elsewhere	Used when iron deficiency anemia occurs with chronic inflammatory conditions and oral iron is ineffective
`N92.0`	Excessive and frequent menstruation with regular cycle	A common cause of iron deficiency anemia in women leading to IV iron use

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	May be used for billing infusion administration time when facility or payer requires a chemo/infusion administration CPT for IV iron infusions in outpatient settings
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Commonly used to report infusion administration services for therapeutic IV infusions like ferumoxytol when payer policies permit
`36415`	Collection of venous blood by venipuncture	Used for pre- and post-infusion laboratory draws (CBC, ferritin, iron studies)
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for the ordering provider visit or follow-up visit related to iron therapy management
`95115`	Professional services for allergen immunotherapy not related to ferumoxytol (placeholder)	Data not available in the input.

HCPCS Level II Q4139: Injectable Amniomatrix or Biodmatrix, 1 cc

HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

HCPCS Level II Q4256: Area-Based Procedural Add-On, Per sq cm

HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

HCPCS Level II Q5132: Adalimumab-afzb (Abrilada) 10 mg Injection

HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

HCPCS Q0035: Cardiokymography, Cardiac Motion Recording

HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

HCPCS Q0081: Infusion Therapy, Non-Chemotherapeutic, Per Visit

HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

HCPCS Q0083: Chemotherapy Administration, Non-Infusion

HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

HCPCS Q0085: Chemotherapy Administration, Infusion Plus Other Technique(s) per Visit

HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

HCPCS Q0091: Screening Pap Smear Specimen Collection and Transport

HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

HCPCS Q0092: Set-up of Portable X-Ray Equipment

Showing 1–10 of 629

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS Q0138: Ferumoxytol Injection for Iron Deficiency Anemia, Non-ESRD

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Billing Code Overview

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HCPCS Q0138: Ferumoxytol Injection for Iron Deficiency Anemia, Non-ESRD

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS Q0138: Ferumoxytol Injection for Iron Deficiency Anemia, Non-ESRD

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Billing Code Overview

HCPCS Q0138: Ferumoxytol Injection for Iron Deficiency Anemia, Non-ESRD

Sign up for hcpcs Q0138 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code Q0138 represent and where is it typically administered?

How is Q0138 billed and what documentation is required?

Which modifiers are relevant to Q0138 and when should they be used?

What clinical scenario and monitoring are described for patients receiving ferumoxytol under Q0138?

Which payers are noted for coverage considerations and does the page provide specific coverage rules?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code Q0138 represent and where is it typically administered?

How is Q0138 billed and what documentation is required?

Which modifiers are relevant to Q0138 and when should they be used?

What clinical scenario and monitoring are described for patients receiving ferumoxytol under Q0138?

Which payers are noted for coverage considerations and does the page provide specific coverage rules?

References