CurrentBlue Cross Blue Shield - TennesseePolicy N/A

Diagnostic Testing of Iron Homeostasis & Metabolism

This policy defines coverage, limitations, and scientific rationale for laboratory testing of iron status (including ferritin, transferrin/transferrin saturation, hepcidin, and related tests) for Blue Cross Blue Shield - Tennessee members and describes when tests meet or do not meet coverage criteria.

Policy Summary

PayerBlue Cross Blue Shield - Tennessee

PolicyDiagnostic Testing of Iron Homeostasis & Metabolism

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionOrder ferritin and transferrin/TSAT testing only when clinical indications or guideline thresholds are met and document the clinical rationale.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

ferritinmeets coverage

TSATmeets coverage

hepcidinnot covered

GlycAnot covered

<30 μg/Lferritin threshold

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Coverage Criteria for Iron Studies

inv-01: Covered indications — ferritin and transferrin/TSAT

Covered when ANY of the following are met for serum ferritin:

Ferritin coverage: a) Evaluation of an individual with abnormal hemoglobin and/or hematocrit levels; b) Evaluation and monitoring of iron overload disorders; c) Individuals with symptoms of hemochromatosis; d) Individuals with first-degree relatives with confirmed hereditary hemochromatosis; e) Evaluation of individuals with liver disease; f) Evaluation and monitoring of patients with chronic kidney disease who are being considered for, or are receiving, treatment for anemia (testing frequency every 1 to 3 months); g) Evaluation of hemophagocytic lymphohistiocytosis (HLH) and Still's Disease; h) For individuals on iron therapy (monitoring frequency every 1 to 3 months); i) Males with secondary hypogonadism.

From policy Indications and Limitations of Coverage

Transferrin/TSAT coverage: a) Evaluation of iron overload in individuals with symptoms of hemochromatosis; b) Evaluation of iron overload in individuals with first-degree relatives with confirmed hereditary hemochromatosis; c) Evaluation of iron deficiency anemia (using serum iron and iron binding capacity to calculate transferrin saturation).

Transferrin saturation using serum iron and serum iron binding capacity (policy)

inv-02: Not Medically Necessary / Not Covered

Not covered tests and uses:

Screening asymptomatic: Use of ferritin or transferrin measurement, including transferrin saturation, as a screening test in asymptomatic patients

Does not meet coverage criteria

Hepcidin tests: Serum hepcidin testing, including immunoassays

Does not meet coverage criteria due to insufficient published evidence

GlycA for transferrin: Use of GlycA testing to measure or monitor transferrin or other glycosylated proteins

Does not meet coverage criteria

inv-03: Guideline-consistent testing

Covered when consistent with guideline-based indications and associated thresholds:

Evaluation for iron deficiency or overload: Testing (serum ferritin, serum iron, TIBC, transferrin saturation) is indicated when clinical suspicion or guideline thresholds are met (e.g., HEIRS: ferritin >200 ng/mL in women or >300 ng/mL in men prompts additional testing; AGA: use ferritin cutoff 45 ng/mL over 15 ng/mL when diagnosing iron deficiency in patients with anemia).see node text

Inflammation or CKD may require adjunct tests (CRP, TSAT, soluble transferrin receptor, hepcidin)

Peri-operative and surgical patients: Serum ferritin measurement is considered the most sensitive and specific test for identification of absolute iron deficiency in the peri-operative setting (international consensus).not specified

Used to guide peri-operative management of anemia

Evaluation of abnormal liver chemistries:

inv-04: Monitoring criteria

Monitoring and follow-up testing:

During ESA therapy: Baseline and periodic monitoring of serum iron, TIBC, transferrin saturation, or ferritin is recommended during ESA treatment to optimize hemoglobin response and reduce transfusions.periodic as clinically indicated

Document monitoring during ESA therapy; KDIGO/KDOQI recommend testing prior to initiation, monthly during initial treatment, and at least every 3 months after stabilization

IBD patients: For IBD surveillance, CBC, serum ferritin, and CRP should be used for laboratory screening; in remission or mild disease measure every 6–12 months and in active disease more frequently.every 6-12 months in remission/mild; more frequent if active

ECCO recommendation

The policy excludes the use of serum ferritin or transferrin measurements as routine screening tests in asymptomatic individuals. Specifically, use of ferritin or transferrin measurement — including transferrin saturation — as a screening test in patients without symptoms does not meet coverage criteria and may be denied.

A systematic review and meta-analysis found low‑certainty evidence that a ferritin threshold of 30 μg/L is reasonably sensitive and very specific for iron deficiency, and very low certainty that high ferritin concentrations detect iron overload. The authors concluded there is insufficient evidence to support using ferritin concentrations to diagnose iron deficiency or overload in asymptomatic people.

The U.S. Preventive Services Task Force (USPSTF) concludes the evidence is insufficient (Grade I) to assess the balance of benefits and harms of routine screening for iron deficiency anemia in pregnant women and in children ages 6 to 24 months; therefore routine population screening is not supported by the USPSTF statements cited.

Selected reference materials and primary studies are cited to inform interpretation of iron biomarkers and clinical guidance. These reference‑only citations provide background and supporting evidence but do not themselves introduce additional explicit coverage exclusions beyond those stated in the policy.

The policy considers serum hepcidin testing (including immunoassays) and GlycA testing for assessment of transferrin or other glycosylated proteins to not meet coverage criteria. GlycA cannot accurately quantify individual glycoproteins (including transferrin) due to signal overlap, and hepcidin assays lack sufficient published evidence of clinical utility for routine use.

Consistent with the meta-analysis findings and policy statements, the available evidence does not support use of ferritin concentrations alone to diagnose iron deficiency or iron overload in asymptomatic individuals. The policy therefore does not endorse routine diagnostic use of ferritin for asymptomatic screening due to insufficient and low‑certainty evidence.

Several cited studies and reviews are provided for clinicians and reviewers as background or methodological context. These reference‑only chunks do not state new not‑medically‑necessary determinations beyond the explicit policy exclusions and guidance.

When Testing Is Covered

inv-48: Evaluation of abnormal hemoglobin/hematocrit; evaluation/monitoring of iron overload; symptoms of hemochromatosis; first-degree relatives with hereditary hemochromatosis; liver disease; CKD patients being considered for or receiving anemia treatment; HLH and Still's disease; monitoring during iron therapy; males with secondary hypogonadism.

Evaluation and monitoring: Evaluation of abnormal hemoglobin/hematocrit; evaluation and monitoring of iron overload; individuals with symptoms of hemochromatosis; first-degree relatives with hereditary hemochromatosis; evaluation of individuals with liver disease; patients with chronic kidney disease being considered for, or receiving, anemia treatment; evaluation of hemophagocytic lymphohistiocytosis (HLH) and Still's disease; monitoring during iron therapy; males with secondary hypogonadism.see respective guidance

From policy Indications and Limitations of Coverage

inv-49: Evaluation of suspected iron deficiency or iron overload — Includes ferritin, transferrin saturation, serum iron, TIBC; ferritin measurement recommended as sensitive/specific for absolute iron deficiency.

Suspected iron deficiency or overload:

Coding and Thresholds

Covered tests (descriptive group from policy)neutralCovered

No codes listed

Not covered tests (descriptive group from policy)neutralNot Covered

No codes listed

Serum ferritin — general iron deficiency threshold

Serum ferritin threshold (general population)< 30 μg/L

ContextSensitive and specific indicator for iron deficiency but can be misleading with concurrent inflammation

Source guidanceDignass et al. (2018) recommendation cited in policy

Ferritin and TSAT — thresholds in inflammatory conditions (CHF, CKD, IBD)

Inflammatory conditions thresholdFerritin <100 μg/L OR transferrin saturation (TSAT) <20%

Intermediate ferritin rangeIf ferritin is 100–300 μg/L, TSAT <20% is required to confirm iron deficiency

Testing Frequency and Monitoring Intervals

Monitoring frequency — ferritin for CKD and iron therapy

CKD and anemia therapy monitoring frequencyEvery 1 to 3 months

Applies toPatients with chronic kidney disease being considered for or receiving treatment for anemia, and individuals on iron therapy

Policy noteListed as an indicated monitoring interval in the reimbursement policy

Monitoring frequency — CBC, ferritin, CRP (IBD)

IBD surveillance frequencyCBC, serum ferritin, and CRP every 6–12 months

Active diseaseIn outpatients with active IBD, measurements should be performed more frequently than every 6–12 months

Provider Actions, Documentation, and Authorization

Prior Authorization

Benefit-dependent prior authorization

Application of coverage criteria is dependent upon an individual's benefit coverage at the time of the request. Providers should verify member benefit coverage and any plan-specific requirements prior to ordering tests.

Measure serum ferritin for: evaluation of abnormal hemoglobin/hematocrit; evaluation/monitoring of iron overload disorders; individuals with symptoms of hemochromatosis; first-degree relatives of confirmed hereditary hemochromatosis; evaluation of liver disease; monitoring patients with chronic kidney disease being considered for or receiving anemia treatment (every 1–3 months); evaluation of hemophagocytic lymphohistiocytosis (HLH) and Still's Disease; individuals on iron therapy (every 1–3 months); males with secondary hypogonadism.

Documentation Required

Required clinical documentation

Documentation must support the clinical indication for testing. Include relevant clinical data such as abnormal hemoglobin/hematocrit values, signs or symptoms (e.g., joint pain, fatigue, unexplained weight loss, abnormal skin pigmentation, abdominal pain, loss of sex drive), family history of hereditary hemochromatosis, liver disease status, CKD stage and anemia treatment status, or other specific clinical concerns.

Ordering Requirements and Test Performance

Billing Rule

Ordering must align with indicated clinical scenarios

Order testing only in the context of an indicated clinical scenario as described in the covered indications; applicability may depend on the member's benefit coverage at the time of request.

Billing Rule

Order tests guided by clinical context or guidelines

Order ferritin/iron studies when clinical context or guideline recommendations indicate (for example, abnormal liver chemistries, anemia evaluation); involve specialists (gastroenterology, hematology, endocrinology) when appropriate per guideline suggestions.

Documentation Required

Confirm CLIA certification for LDTs

Ensure laboratory-developed tests are validated and performed in a CLIA-certified laboratory; ordering providers should confirm appropriate lab certification prior to ordering LDTs.

Tests and Uses Not Covered

Serum hepcidin immunoassays and GlycA testing are specifically listed in the policy as not meeting coverage criteria. Hepcidin assays have reported analytical variability and potential cross‑reactivity, and GlycA is unable to distinguish contributions from individual glycoproteins; therefore both are considered not medically necessary for the purposes described in this policy.

Screening ferritin testing in asymptomatic individuals for the diagnosis of iron deficiency or iron overload is designated as not covered because the evidence is insufficient and of low certainty to support diagnostic accuracy and clinical benefit in asymptomatic populations.

Non‑transferrin‑bound iron (NTBI) and labile plasma iron (LPI) are described in the literature as promising research markers for iron toxicity but lack large validation studies and, per ASH guidance, are not suitable for routine monitoring. The policy therefore treats these assays as investigational/research tools rather than covered standard tests.

The document includes multiple supporting references for clinical interpretation and methodology. These reference‑only segments do not add further specific not‑covered items beyond those explicitly listed in the policy.

Definitions and Test Concepts

Definition — ferritin

Ferritin — definitionProtein that stores intracellular iron; serum ferritin is used as a metric to identify absolute iron deficiency and monitor iron stores

Clinical caveatFerritin is an acute phase reactant and can be elevated by inflammation and liver disease, potentially misleading assessment of iron stores

Role in managementSerum ferritin measurement is considered the most sensitive and specific test for identifying absolute iron deficiency in peri-operative and other settings

Definition — hepcidin

Hepcidin — definitionSmall regulatory peptide hormone that binds ferroportin to reduce iron export and modulate systemic iron homeostasis

Biomarker contextStudied as a biomarker for iron deficiency/overload and in inflammatory conditions but not covered by this policy

Background and Rationale

Iron homeostasis is maintained by regulated absorption, transport, storage, and systemic control. Dietary iron is absorbed by enterocytes, transported in plasma bound to transferrin, and stored intracellularly in ferritin. The hormone hepcidin is the principal systemic regulator: it binds ferroportin and reduces iron export from enterocytes and macrophages, decreasing serum iron availability. Ferritin is widely used as a marker of body iron stores but is also an acute‑phase reactant and can be elevated by inflammation or liver disease. Transferrin saturation (TSAT) reflects the percentage of transferrin bound with iron and, when very high (for example, >85%), is associated with circulating non‑transferrin‑bound iron and potential organ iron deposition.

Policy Revision History

2021-09-28Regulatory update

FDA Devices database search identified 125 ferritin-related device records, noted in state and federal regulations section.

2012-01-01Guideline citation update

KDIGO/KDOQI guidance cited recommending ferritin and TSAT monitoring in CKD and during ESA therapy, including testing frequency recommendations.

2021-01-01Evidence update

Inclusion of Mei et al. (2021) physiologically based serum ferritin thresholds for children and non-pregnant women in the references informing threshold guidance.

Policy Summary

PayerBlue Cross Blue Shield - Tennessee

PolicyDiagnostic Testing of Iron Homeostasis & Metabolism

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionOrder ferritin and transferrin/TSAT testing only when clinical indications or guideline thresholds are met and document the clinical rationale.

SourceLink

On This Page

All patients with abnormal liver chemistries (in the absence of acute hepatitis) should undergo testing for hereditary hemochromatosis with iron level, transferrin saturation, and serum ferritin (ACG strong recommendation).

Testing to evaluate for hereditary hemochromatosis

Evaluation includes serum ferritin, transferrin saturation (calculated from serum iron and TIBC), serum iron, and TIBC; serum ferritin is recommended as a sensitive and specific test for absolute iron deficiency and is appropriate for initial hereditary hemochromatosis evaluation.

see guideline thresholds (e.g., HEIRS ferritin >200/300 ng/mL)

Use adjunct tests in inflammatory states

inv-50: Monitoring during ESA treatment or assessing responsiveness to IV iron — Baseline and periodic iron studies; RET-He can predict responsiveness to IV iron.

ESA treatment monitoring / IV iron responsiveness: Baseline and periodic iron studies (iron, TIBC, transferrin saturation, ferritin) are recommended during ESA therapy; RET-He (reticulocyte hemoglobin equivalent) can help predict responsiveness to intravenous iron.periodic as clinically indicated; KDIGO guidance for frequency

Document monitoring per payer guidance

inv-51: Surveillance in IBD patients — CBC, ferritin, and CRP every 6-12 months in remission/mild disease; more frequently in active disease.

IBD surveillance: For patients with inflammatory bowel disease, use CBC, serum ferritin, and CRP for laboratory screening; in remission or mild disease perform these measurements every 6–12 months; in active disease monitor more frequently.every 6-12 months in remission/mild; at least every 3 months if active

ECCO guideline (EL-5)

inv-52: Evaluation and monitoring of iron deficiency and anemia in conditions such as IBD and CKD, including pre-treatment assessment and periodic monitoring during therapy.

Evaluation and monitoring in IBD and CKD: Evaluation and monitoring of iron deficiency and anemia in conditions such as IBD and CKD should include CBC, serum ferritin, and CRP for IBD, and ferritin plus TSAT for CKD; pre-treatment assessment and periodic monitoring during therapy should follow guideline-recommended intervals.see KDIGO/KDOQI and ECCO recommendations (e.g., monthly during initial CKD treatment, every 3 months after stabilization; IBD every 6–12 months in remission)

Use adjunct tests when inflammation/CKD present

inv-53: Peri-operative assessment of anemia and iron deficiency — serum ferritin cited as most sensitive and specific for absolute iron deficiency in surgical patients.

Peri-operative assessment of anemia and iron deficiency: serum ferritin measurement is the most sensitive and specific test for identifying absolute iron deficiency and is used to guide peri-operative management of anemia.not specified

International consensus statement on peri-operative management

inv-54: Assessment of iron deficiency, iron overload, and related anemia evaluations as discussed in referenced guidelines and studies.

Guideline and study-based assessment: Assessment of iron deficiency, iron overload, and related anemia evaluations as discussed in referenced guidelines and studies (WHO, KDIGO, KDOQI, HEIRS, and peer-reviewed literature).see cited references for specific thresholds

References include physiologically based ferritin thresholds and guideline recommendations

Applicable populationsReferenced for CHF, CKD, and IBD patients

Extremely elevated ferritin — Still disease / HLH consideration

Extremely elevated ferritin threshold> 5× upper limit of normal

Clinical implicationMay indicate adult-onset Still disease in the appropriate clinical context

Further elevationValues above ~10,000 μg/L raise concern for hemophagocytic syndromes (HLH) in autoimmune or infectious contexts

Ferritin thresholds — examples and guideline-referenced cutoffs

HEIRS follow-up thresholdsFerritin >200 ng/mL (women) or >300 ng/mL (men) — warrants additional testing

AGA diagnostic cutoff in anemiaAGA suggests 45 ng/mL cutoff (preferred over 15 ng/mL) when using ferritin to diagnose iron deficiency in patients with anemia

WHO examplesWHO provides age- and inflammation-specific cutoffs (e.g., <12 μg/L infants; <15 μg/L adults; overload >150 μg/L females, >200 μg/L males)

Transferrin saturation (TSAT) — risk threshold for NTBI

TSAT risk threshold for NTBI85% TSAT — non-transferrin-bound iron (NTBI) begins to circulate

Clinical riskCirculating NTBI/LPI increases risk for endocrine and cardiac iron accumulation

Interpretation caveatTSAT values may be invalid if iron chelators are present in the bloodstream; withhold chelation before measurement

Serum ferritin — physiology-based threshold study (Mei et al. 2021)

Study-based physiologic thresholdsPhysiologically based serum ferritin thresholds described (Mei et al., 2021) for children and non-pregnant women

PurposeProvides age- and sex-specific reference thresholds derived from NHANES data

ReferenceMei et al., Lancet Haematol 2021 as cited in policy

ECCO 2015 recommendation cited in policy

Monitoring frequency — serum ferritin during chelation

Ferritin monitoring during chelationEvery 3–6 weeks (so running averages can be calculated)

PurposeFrequent checks correct for transient fluctuations due to inflammation or liver damage

GuidelineAmerican Society of Hematology recommendation

Monitoring frequency — ferritin and TSAT during CKD/ESA therapy

Initial CKD/ESA monitoring frequencyMonthly during initial treatment; at least every 3 months after stabilization

TestsSerum ferritin and TSAT recommended at these intervals

Guideline sourcesKDOQI and KDIGO guideline recommendations cited in policy

Monitoring frequency — CBC, ferritin, CRP (IBD remission vs active)

IBD monitoring intervals (remission vs active)Every 6–12 months in remission/mild disease; at least every 3 months in active disease

TestsCBC, serum ferritin, and CRP

GuidelineECCO 2015 guidance cited in policy

Frequency limits — referenced but unspecified statements

Frequency statements — unspecified detailsReferenced literature includes additional frequency recommendations; specific limits not explicitly specified in policy text

ActionRefer to cited guidelines and primary literature for precise frequency limits when policy is non-specific

NotePolicy includes placeholders where referenced frequency statements exist but are not detailed

For CKD/ESA therapy: document ESA use and monitoring schedule; baseline and periodic iron studies are recommended during ESA treatment.
For iron therapy: document treatment start date and plan for monitoring ferritin/TSAT every 1–3 months as indicated.

Denial Risk

Denial risks for non-covered indications

Use of ferritin or transferrin (including transferrin saturation) as a screening test in asymptomatic patients does not meet coverage criteria and may be denied. Serum hepcidin testing and GlycA testing to measure or monitor transferrin or other glycosylated proteins do not meet coverage criteria and may be denied.

Asymptomatic screening with ferritin/TSAT — denial risk.
Serum hepcidin testing (including immunoassays) — denial risk.
GlycA testing for transferrin/glycosylated proteins — denial risk.

Documentation Required

Iron monitoring during ESA treatment and IBD

Baseline and periodic monitoring of iron studies (iron, TIBC, TSAT, ferritin) is recommended during ESA treatment to optimize hemoglobin response and reduce transfusions; follow relevant specialty guidance (KDIGO, KDOQI, ECCO) for frequency recommendations.

KDIGO/KDOQI: test TSAT and ferritin at least every 3 months for patients on ESA therapy; test more frequently when initiating/increasing ESA dose, after blood loss, after IV iron, or when iron stores may be depleted.
ECCO (IBD): perform CBC, ferritin, and CRP every 6–12 months in remission/mild disease and more often in active disease.

Note

Laboratory certification and LDT risk

Laboratory-developed tests (LDTs) used for ferritin/hepcidin must comply with CLIA high-complexity validation requirements. Lack of appropriate laboratory validation or use of non-validated LDTs may affect coverage and reimbursement.

Verify that testing laboratory is CLIA-certified for high-complexity testing.
FDA clearance is not required for LDT clinical use, but proper validation documentation is expected for coverage.

Prior Authorization

Prior authorization

No prior authorization is required by default from this policy section; however, benefit-dependent prior authorization or plan-specific authorization requirements may apply. Providers should confirm whether the patient's specific Blue Cross Blue Shield - Tennessee plan requires authorization before testing.

If the member's benefit requires prior authorization, obtain it prior to testing to avoid claim denials.
There are no additional denial triggers specified beyond the coverage/non-coverage items noted above.

Note

Ordering provider restrictions

These reference-only chunks do not impose specific ordering provider restrictions.

MechanismHepcidin activation causes ferroportin endocytosis and degradation, reducing serum iron availability

Ferritin thresholds — definition and interpretation

Ferritin thresholds — overviewPolicy references multiple ferritin cutoffs that vary by age, sex, inflammation status, and clinical context

ExamplesIncludes HEIRS thresholds (>200 ng/mL women, >300 ng/mL men), WHO age/inflammation cutoffs, and AGA/clinical recommendations

InterpretationInflammation and CKD may necessitate adjunctive testing (CRP, TSAT, sTfR) to interpret ferritin

Definition — RET‑He (reticulocyte hemoglobin equivalent)

RET-He — definitionReticulocyte hemoglobin equivalent (RET‑He) — a CBC-derived parameter that can identify iron deficiency and predict response to IV iron

Diagnostic performanceRET‑He identified iron deficiency with 68.2% sensitivity and predicted IV iron responsiveness with 84% sensitivity in cited study

Clinical useCan help determine need for and responsiveness to intravenous iron and speed therapeutic decisions

Definition — Hepcidin (regulatory peptide)

Hepcidin — regulatory rolePeptide hormone that regulates systemic iron by binding ferroportin, inducing its degradation and decreasing iron export

Research/clinical roleStudied as a biomarker in inflammation, CKD, and other conditions but is not covered by this policy due to insufficient evidence

InteractionHepcidin production is influenced by transferrin receptor signaling and iron concentrations

Definition — Serum ferritin (clinical use)

Serum ferritin — clinical metricCommonly used to identify absolute iron deficiency and to monitor iron stores; sensitive but affected by inflammation

Peri-operative useInternational consensus cites serum ferritin as the most sensitive and specific test to identify absolute iron deficiency prior to surgery

Interpretation noteNormal ferritin may be misleading in inflammation; adjunctive tests may be required

Definition — Transferrin saturation (TSAT)

TSAT — definitionTransferrin saturation (TSAT) — the percentage of transferrin bound with iron

Risk thresholdTSAT >85% associated with NTBI emergence and risk for tissue iron accumulation

LimitationsTSAT interpretation may be confounded by concurrent iron chelators in blood; withhold chelation prior to testing

Definition — NTBI / LPI (research markers)

NTBI/LPI — research statusNon-transferrin-bound iron (NTBI) and labile plasma iron (LPI) indicate circulating redox-active iron and are of research interest but not yet suitable for routine monitoring

Clinical implicationSome studies link elevated LPI/NTBI to cardiac iron accumulation, but large validation studies are lacking

Policy stanceDescribed as important and interesting research tools, not routine tests

Serum ferritin thresholds — physiology-based study (children & non-pregnant women)

Physiology-based ferritin thresholdsStudy provides physiologically based serum ferritin thresholds for children and non-pregnant women

Data sourceDerived from NHANES serial cross-sectional analyses (Mei et al., 2021)

UseOffers age- and sex-specific thresholds to supplement guideline interpretations

CKD anemia guidelines — KDIGO / KDOQI references

CKD anemia guidance referencesKDIGO and KDOQI guidelines referenced for anemia management in CKD and monitoring recommendations

Key recommendationsUse ferritin and TSAT to define iron stores; test monthly during initial treatment and at least every 3 months after stabilization (KDOQI/KDIGO)

Policy applicationThese guidelines inform monitoring and documentation expectations for CKD patients on ESA or iron therapy

Policy effectiveLatest

Policy documents compiled to define coverage criteria for serum ferritin and transferrin/TSAT testing; exclusions for hepcidin and GlycA testing specified.