L95.9 — Vasculitis limited to the skin, unspecified
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
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.
- For coverage criteria of autoimmune mucocutaneous blistering diseases, reference CMS Internet-Only Manual, Pub. 100-03, Medicare NCD Manual, Chapter 1, Part 4, §250.3.
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.
2 Active Policies
A56718 — Billing and Coding: Intravenous Immunoglobulin (IVIG)
L34580 — Intravenous Immunoglobulin (IVIG)
Related Codes
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