From the Guidelines
Medical necessity for ordering iron studies is supported by several ICD-10 codes related to conditions where iron metabolism may be affected, including D50.0-D50.9, D53.9, D64.0-D64.9, K50-K52, N18.1-N18.9, C00-C97, R71.0, Z79.899, and Z33.1-Z39.2, as recommended by recent guidelines 1. The most common codes include:
- D50.0-D50.9 (Iron deficiency anemia)
- D53.9 (Nutritional anemia, unspecified)
- D64.0-D64.9 (Other anemias)
- K50-K52 (Inflammatory bowel diseases)
- N18.1-N18.9 (Chronic kidney disease)
- C00-C97 (Malignant neoplasms)
- R71.0 (Abnormality of red blood cells)
- Z79.899 (Long term use of high-risk medications)
- Z33.1-Z39.2 (Pregnancy and postpartum states) Additional relevant codes include:
- D63.1 (Anemia in chronic kidney disease)
- D63.0 (Anemia in neoplastic disease)
- R53.83 (Fatigue) Iron studies are typically ordered when patients present with symptoms of anemia, unexplained fatigue, poor growth in children, or when monitoring patients with conditions that affect iron absorption or utilization, as suggested by the American Association for the Study of Liver Diseases 1 and the American College of Physicians 1. These tests help clinicians assess iron status by measuring serum iron, total iron binding capacity, transferrin saturation, and ferritin levels, and are recommended by the ESPEN micronutrient guideline 1 to investigate both suspected deficiency and overload. The medical necessity for these tests is based on their ability to diagnose iron deficiency, iron overload, or to monitor response to iron supplementation therapy in patients with established diagnoses, and is supported by the latest evidence 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
ICD-10 Codes for Medical Necessity of Iron Studies
The following ICD-10 codes may support medical necessity for ordering iron studies:
- D50.0: Iron deficiency anemia secondary to chronic blood loss (chronic)
- D50.1: Iron deficiency anemia secondary to acute blood loss
- D50.8: Other iron deficiency anemias
- D50.9: Iron deficiency anemia, unspecified
- E61.1: Deficiency of iron, due to chronic blood loss, or increased demand during pregnancy or lactation
- E61.2: Deficiency of iron, due to inadequate dietary intake
- E61.3: Deficiency of iron, due to malabsorption
- E61.8: Other deficiencies of iron
- E61.9: Deficiency of iron, unspecified
Conditions that May Require Iron Studies
Iron studies may be necessary for patients with the following conditions:
- Anemia 2, 3, 4, 5
- Chronic kidney disease 2, 3
- Heart failure 3
- Inflammatory bowel disease 3
- Cancer 3
- Pregnancy or lactation 3, 4
- Menstrual bleeding or other causes of chronic blood loss 3, 5
- Malabsorption or inadequate dietary intake of iron 3, 6
Diagnostic Criteria for Iron Deficiency
Iron deficiency can be diagnosed using the following tests: