Provider Alert! Treatment Indications to Change for Ferric CarboxymaltoseTexas Children's Health Plan
Date: June 17, 2022
Attention: All Providers
Effective Date: July 1, 2022
Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.
TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal claims unless denied for other reasons.
Providers should direct questions to their Provider Relations Liaison or send an email inquiry to the Provider Relations Department at firstname.lastname@example.org.
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective July 1, 2022, ferric carboxymaltose (procedure code J1439) will be restricted to patients who are one year and older and treatment indications will be updated.
How this impacts providers: Beginning July 1, 2022, ferric carboxymaltose (procedure code J1439) may be indicated for but not limited to treatment of iron deficiency anemia for the following:
- Adult and pediatric clients who are one year of age or older with intolerance or unsatisfactory response to oral iron
- Adult clients with non-dialysis-dependent chronic kidney disease
Next steps for providers: Providers should share this update with their staff.
If you have any questions, please email Provider Network Management at: email@example.com.