Each 1 mg of ferumoxytol administered by intravenous injection

Ferumoxytol (Feraheme) is an IV iron replacement product indicated for iron deficiency anemia (IDA) in adults with chronic kidney disease (CKD) or in adults who have intolerance to oral iron or have had unsatisfactory response to oral iron. This code is billed per 1 mg of ferumoxytol administered, requiring units to reflect the total milligrams infused. The drug is an iron oxide nanoparticle formulation that also has off-label use as an MRI contrast agent.

This code applies when ferumoxytol is administered intravenously in an outpatient or non-facility setting, such as an infusion center or physician office. The standard therapeutic dose is 510 mg per injection (two doses of 510 mg separated by 3–8 days), so billing would typically reflect 510 units per infusion encounter. Supporting documentation should include the diagnosis of IDA with CKD or documented oral iron intolerance/failure, the ordered dose in milligrams, and the route of administration.

• Unit calculation is critical: Bill units equal to the total milligrams administered (e.g., 510 mg = 510 units); undercoding or defaulting to 1 unit is a common and costly error.
• Pair with the appropriate administration code (e.g., 96365 for initial IV infusion, 96366 for additional hours) and ensure the infusion time is documented to support the administration level billed.
• Verify payer-specific coverage policies: Medicare covers ferumoxytol for CKD-related IDA, but some commercial payers require prior authorization or restrict coverage to specific diagnoses; off-label MRI contrast use is generally non-covered and may require an ABN.