Intravenous Immune Globulin - Policy Article

IVIG administered in the home for primary immunodeficiency is covered when the product is an approved pooled plasma derivative, the patient has a documented diagnosis of primary immunodeficiency, and the treating practitioner documents that home administration is medically appropriate. Coverage and payment require compliance with Final Rule 1713 face-to-face and WOPD requirements where applicable, correct billing of HCPCS Q2052 (one paid unit per infusion date) and proper application of JW/JZ modifiers per the stated scenarios and effective dates.

"IVIG is covered when the product is an approved pooled plasma derivative indicated for treatment of primary immunodeficiency disease."

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