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On anemia claims, CO-50 most commonly fires on IV iron infusion claims where D64.9 is submitted without lab evidence of iron deficiency or without documented failure of oral iron therapy

In summary, for CY 2026, we are finalizing our proposal to use available claims data for CPT code 0662T to finalize the APC assignment for CPT code 97007 to APC 1516 (New TechnologyLevel 16 ($1,401-$1,500) with a payment rate of $1,450.50 and status indicator S. We are also finalizing our proposals to assign CPT codes 97008 and 97009 to status indicator N for CY 2026

Ohtsu, E., Ichiyama, A., Nishizuka, Y

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