J2792 — Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Claims should reference and be supported by LCD L34580 and follow the billing/coding guidelines in this article; specific documentation requirements (e.g., medical records, prior authorization) are those detailed in LCD L34580.
- Signed and dated office visit records and operative reports are required; all services ordered or rendered to Medicare beneficiaries must be signed.
- For services requiring a referring/ordering physician, the referring/ordering physician's name and NPI must be reported on the claim.
- The patient's medical record must include the ordering provider's assessment related to the patient's complaint for that visit and relevant medical history.
Key Coverage Criteria
- Billing and coding for intravenous immunoglobulin (IVIG) should follow the Local Coverage Determination (LCD) L34580 and the billing/coding guidelines in this article as a complement to that LCD.
- IVIG is covered for hyperimmunoglobulinemia E (hyper-IgE) syndrome.
- IVIG is covered for Lambert-Eaton myasthenic syndrome (LEMS).
- IVIG is covered for multifocal motor neuropathy (MMN).
- IVIG is covered for relapsing-remitting multiple sclerosis (RRMS).
- IVIG is covered for adults with Guillain-Barré syndrome (GBS) diagnosed within the first 2 weeks of illness.
4 Active Policies
A56718 — Billing and Coding: Intravenous Immunoglobulin (IVIG)
A57160 — Billing and Coding: Immune Thrombocytopenia (ITP) Therapy
L38268 — Immune Thrombocytopenia (ITP) Therapy
L34580 — Intravenous Immunoglobulin (IVIG)
Related Codes
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