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Independence Blue CrossMedicare Advantage · Coverage · Medical Policy · Hematology, Oncology, Nephrology +4 moreMedium impact

MA08.150a, Intravenous (IV) Iron Preparations

Act
by Mar 23, 2026
Effective date
Mar 23, 2026
Identified
Jun 19, 2026

Summary

Independence Blue Cross Medicare Advantage policy MA08.150b (effective 03/23/2026) supersedes MA08.150a with new coverage criteria for IV iron in pediatric patients and expanded ICD-10 diagnosis codes including pregnancy-related anemia (O99.011-O99.013, O99.019, O99.02, O99.03) and chemotherapy-induced anemia (D64.81). The policy maintains preferred vs. nonpreferred product tiering for adults 18+ and excludes preferred product requirements for patients under 18 and pregnant individuals.

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What to do

by Mar 23, 2026 · 6 steps
01Billing team must update claims processing system to recognize new ICD-10 codes D64.81 (chemotherapy-induced anemia) and O99.011, O99.012, O99.013, O99.019, O99.02, O99.03 (pregnancy-related anemia) as covered indications for IV iron.
02Update prior authorization workflows to remove preferred product requirements for patients under age 18 and pregnant individuals—these populations can receive any designated IV iron product without step-therapy.
03Verify that nonpreferred product criteria (requiring documentation of contraindication, intolerance, or inadequate response to 2+ preferred products) remain enforced for all other adults.
04Update clinical staff and providers on expanded pediatric coverage criteria.
05Test billing system changes against all affected HCPCS codes (A9574, J1437, J1439, J1750, J1756, J2916, Q0138, Q0139) before effective date.
06Claims submitted without proper coding or authorization after this date will be denied.

Codes mentioned

A9574J1437J1439J1750J1756J2916Q0138Q0139D50.0D50.8D50.9D63.0D63.1D64.81E61.1O99.011O99.012O99.013O99.019O99.02O99.03

Original notice

MA08.150a, Intravenous (IV) Iron Preparations
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
MA08.150a, Intravenous (IV) Iron PreparationsMediumEffective Mar 23, 2026 · Medical Policy08.02.29a, Intravenous (IV) Iron PreparationsMediumEffective Mar 23, 2026 · Medical Policy08.02.29a, Intravenous (IV) Iron PreparationsMediumEffective Mar 23, 2026 · Medical PolicyMA08.150, Intravenous (IV) Iron PreparationsHighEffective Jan 1, 2025 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesHematologyOncologyNephrologyOB-GYNPediatricsCardiologyInternal MedicineCode A9574Code J1437Code J1439Code J1750Code J1756Code J2916Code Q0138Code Q0139Code D50.0Code D50.8Code D50.9Code D63.0Code D63.1Code D64.81Code E61.1Code O99.011Code O99.012Code O99.013Code O99.019Code O99.02Code O99.03

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