Billing Coding Brochure - Iron Deficiency Anemia Treatment

FERAHEME? (ferumoxytol injection) Billing and Coding Information for Outpatient Services*

FERAHEME is indicated for the treatment of iron deficiency anemia (IDA) in adult patients: ? who have intolerance to oral iron or have had unsatisfactory response to oral iron or ? who have chronic kidney disease (CKD)

FERAHEME product and administration codes

HCPCS1

Injection, ferumoxytol, for treatment of IDA, 1 mg Q0138 non-ESRD use OR Q0139 ESRD on dialysis

Drug administration CPT? codes2

96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

National Drug Codes (NDC)3

59338-0775-01 FERAHEME 510 mg/17 mL, 1 vial 59338-0775-10 FERAHEME 510 mg/17 mL, 10 vials

*This table is provided for informational purposes only. Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and specific billing requirements. AMAG Pharmaceuticals, Inc. does not make any representation or guarantees concerning reimbursement or coverage for any service or item. CPT? is a registered trademark of the American Medical Association. Payer requirements regarding 10-digit and 11-digit NDC may vary. CPT: Current Procedural Terminology; ESRD: end-stage renal disease; HCPCS: Healthcare Common Procedure Coding System.

Feraheme? (ferumoxytol injection) Important Safety Information

WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS Fatal and serious hypersensitivity reactions including anaphylaxis have occurred in patients receiving Feraheme. Initial symptoms may include hypotension, syncope, unresponsiveness, cardiac/cardiorespiratory arrest.

? Only administer Feraheme as an intravenous infusion over at least 15 minutes and only when personnel and therapies are immediately available for the treatment of anaphylaxis and other hypersensitivity reactions.

? Observe for signs or symptoms of hypersensitivity reactions during and for at least 30 minutes following Feraheme infusion including monitoring of blood pressure and pulse during and after Feraheme administration.

? Hypersensitivity reactions have occurred in patients in whom a previous Feraheme dose was tolerated.

Please see additional Important Safety Information throughout and accompanying full Prescribing Information, including Boxed Warning.

For questions regarding the billing and coding information above or for resources to support the claims appeal process, call: 844-635-AMAG (2624) Website:

Product, Administration, and Diagnosis Codes*

HCPCS1 Drug administration CPT? codes2 National Drug Codes (NDC)3

Diagnosis codes (ICD-10)4

Injection, ferumoxytol, for treatment of IDA, 1 mg Q0138 non-ESRD use OR Q0139 ESRD on dialysis

96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

59338-0775-01 FERAHEME 510 mg/17 mL, 1 vial 59338-0775-10 FERAHEME 510 mg/17 mL, 10 vials

D50.0 Blood loss (chronic) D50.1 Sideropenic dysphagia D50.8 Poor iron absorption D50.9 Iron deficiency anemia, unspecified

Confirm iron deficiency before using the following codes: D63.0 Anemia in neoplastic disease

CODE NEOPLASM FIRST D63.1 Anemia in chronic kidney disease

CODE CKD STAGE D63.8 Anemia in other chronic diseases classified elsewhere

CODE UNDERLYING DISEASE FIRST D64.81 Antineoplastic chemotherapy-induced anemia

Feraheme Important Safety Information (cont'd)

Contraindications Feraheme is contraindicated in patients with known hypersensitivity to Feraheme or any of its components or a history of allergic reaction to any intravenous iron product.

Warnings and Precautions Hypersensitivity: In addition to the fatal and serious adverse reactions in the Boxed Warning, other adverse reactions associated with hypersensitivity have occurred (pruritus, rash, urticaria, and wheezing). Allergic reactions have occurred following the first dose or subsequent doses in patients in whom a previous dose was tolerated. Patients with a history of multiple drug allergies may have a greater risk of anaphylaxis with parenteral iron products. Carefully consider the potential risks and benefits before administering Feraheme to these patients. Elderly patients with multiple or serious co-morbidities who experience hypersensitivity reactions and/or hypotension following administration of Feraheme may have more severe outcomes.

Please see additional Important Safety Information throughout and accompanying full Prescribing Information, including Boxed Warning.

Codes Pertaining to IDA Underlying Conditions*

Diagnosis codes (ICD-10)4

E83.10 Iron metabolism E83.19 Other disorders of iron metabolism, specified NEC K50.00, K50.90, K50.919 Crohn's disease (regional enteritis) K51.00, K51.90, K51.919 Pancolitis, ulcerative colitis, complication K90.0 Celiac disease K90.49 Malabsorption due to intolerance K90.89 Intestinal malabsorption, specified NEC K90.9 Intestinal malabsorption N18.1 CKD, stage 1 N18.2 CKD, stage 2 N18.3 CKD, stage 3 N18.4 CKD, stage 4 N18.5 CKD, stage 5 N18.6 CKD, end-stage (failure) N18.9 CKD N92.0, N92.6 Excessive, frequent, and irregular menstruation N95.0 Postmenopausal bleeding T45.4X5 [A,S,D] Adverse effect of iron and its compounds T50.905 [A,S,D] A dverse effect of unspecified drugs, medicaments,

and biological substances

*This table is provided for informational purposes only. Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and specific billing requirements. AMAG Pharmaceuticals, Inc. does not make any representation or guarantees concerning reimbursement or coverage for any service or item.

CPT? is a registered trademark of the American Medical Association.

Payer requirements regarding 10-digit and 11-digit NDC may vary.

CKD: chronic kidney disease; NEC: not elsewhere classified; ICD: International Classification of Diseases.

Please see Important Safety Information throughout and accompanying full Prescribing Information, including Boxed Warning.

Feraheme Important Safety Information (cont'd) Warnings and Precautions (cont'd) Hypotension: Feraheme may cause clinically significant hypotension. Monitor patients for signs and symptoms of hypotension following each Feraheme administration. Iron Overload: Excessive therapy with parenteral iron can lead to excess storage of iron with the possibility of iatrogenic hemosiderosis. Regularly monitor the hematologic response during parenteral iron therapy. Do not administer Feraheme to patients with iron overload. Magnetic Resonance (MR) Imaging Test Interference: Administration of Feraheme may transiently affect the diagnostic ability of MR imaging. Alteration of MR imaging studies may persist for up to 3 months following the last Feraheme dose. Maximum alteration of vascular MR imaging is anticipated to be evident for 1 ? 2 days following Feraheme administration. Adverse Reactions The most common adverse reactions ( 2%) are diarrhea, headache, nausea, dizziness, hypotension, constipation, and peripheral edema.

Please see additional Important Safety Information throughout and accompanying full Prescribing Information, including Boxed Warning. Visit for more information.

References: 1. Centers for Medicare & Medicaid Services, US Department of Health and Human Services. HCPCS 2018 index. . Updated February 15, 2018. Accessed April 9, 2018. 2. American Medical Association. Current Procedural Terminology 2017: Professional Edition. Chicago. IL: American Medical Association; 2016. 3. Feraheme [prescribing information]. AMAG Pharmaceuticals, Inc; February 2018. 4. Centers for Medicare & Medicaid Services. 2018 code tables and index. . Accessed April 9, 2018.

AMAG Pharmaceuticals, Inc. 1100 Winter Street, Waltham, MA 02451 AMAG Pharmaceuticals, Feraheme, and the logo designs presented in this material are trademarks of AMAG Pharmaceuticals, Inc. ?2019 AMAG Pharmaceuticals, Inc. All rights reserved. PP-FRH-US-00191 04/2019

HIGHLIGHTS OF PRESCRIBING INFORMATION

These highlights do not include all the information needed to use FERAHEME safely and effectively. See full prescribing information for FERAHEME.

FERAHEME? (ferumoxytol injection), for intravenous use Initial U.S. Approval: 2009

RECENT MAJOR CHANGES

Boxed Warning Indication and Usage (1) Dosage and Administration (2) Warnings and Precautions, Serious Hypersensitivity Reactions (5.1)

02/2018 02/2018 12/2017

02/2018

WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS See full prescribing information for complete boxed warning.

Fatal and serious hypersensitivity reactions including anaphylaxis have occurred in patients receiving Feraheme. Initial symptoms may include hypotension, syncope, unresponsiveness, cardiac/cardiorespiratory arrest.

? Only administer Feraheme as an intravenous infusion over at least 15 minutes and only when personnel and therapies are immediately available for the treatment of anaphylaxis and other hypersensitivity reactions. (5.1)

? Observe for signs or symptoms of hypersensitivity reactions during and for at least 30 minutes following Feraheme infusion including monitoring of blood pressure and pulse during and after Feraheme administration. (5.1)

? Hypersensitivity reactions have occurred in patients in whom a previous Feraheme dose was tolerated. (5.1)

INDICATIONS AND USAGE

Feraheme is an iron replacement product indicated for the treatment of iron deficiency anemia (IDA) in adult patients: ? who have intolerance to oral iron or have had unsatisfactory response to

oral iron (1) or ? who have chronic kidney disease (CKD). (1)

FULL PRESCRIBING INFORMATION: CONTENTS* WARNING: RISK FOR SERIOUS HYPERSENSITIVITY/ANAPHYLAXIS REACTIONS 1 INDICATIONS AND USAGE 2 DOSAGE AND ADMINISTRATION 3 DOSAGE FORMS AND STRENGTHS 4 CONTRAINDICATIONS 5 WARNINGS AND PRECAUTIONS

5.1 Serious Hypersensitivity Reactions 5.2 Hypotension 5.3 Iron overload 5.4 Magnetic Resonance (MR) Imaging Test Interference 6 ADVERSE REACTIONS 6.1 Adverse Reactions in Clinical Studies 6.2 Postmarketing Experience 7 DRUG INTERACTIONS 8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy 8.2 Lactation 8.4 Pediatric Use 8.5 Geriatric Use 10 OVERDOSAGE 11 DESCRIPTION

DOSAGE AND ADMINISTRATION ? The recommended dose of Feraheme is an initial 510 mg dose followed

by a second 510 mg dose 3 to 8 days later. (2) ? Administer Feraheme as an intravenous infusion in 50-200 mL

0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, USP over at least 15 minutes. (2)

DOSAGE FORMS AND STRENGTHS Injection: 510 mg iron per 17 mL (30 mg per mL) in single-dose vials. (3)

CONTRAINDICATIONS ? Known hypersensitivity to Feraheme or any of its components. (4) ? History of allergic reaction to any intravenous iron product. (4)

WARNINGS AND PRECAUTIONS ? Greater risk of anaphylaxis in patients with multiple drug allergies. (5.1) ? Hypotension: Feraheme may cause hypotension. Monitor for signs and

symptoms of hypotension following each administration of Feraheme. (5.2) ? Iron Overload: Regularly monitor hematologic responses during Feraheme

therapy. Do not administer Feraheme to patients with iron overload. (5.3) ? Magnetic Resonance Imaging Test Interference: Feraheme can alter

magnetic resonance imaging (MRI) studies. (5.4)

ADVERSE REACTIONS The most common adverse reactions ( 2%) are diarrhea, headache, nausea, dizziness, hypotension, constipation, and peripheral edema. (6.1)

To report SUSPECTED ADVERSE REACTIONS with Feraheme, contact AMAG Pharmaceuticals, Inc. at 1-877- 411-2510, or FDA at 1-800-FDA-1088 or medwatch.

See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling

Revised: 02/2018

12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action 12.2 Pharmacodynamics 12.3 Pharmacokinetics

13 NONCLINICAL TOXICOLOGY 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

14 CLINICAL STUDIES 14.1 Iron Deficiency Anemia in Patients Who Are Intolerant to Oral Iron or Have Had Unsatisfactory Response to Oral Iron 14.2 Iron Deficiency Anemia in Patients with Chronic Kidney Disease

16 HOW SUPPLIED/STORAGE AND HANDLING 16.1 How Supplied 16.2 Stability and Storage

17 PATIENT COUNSELING INFORMATION

*Sections or subsections omitted from the full prescribing information are not listed.

[no notes on this page]

- 5 -

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download