Billing and Coding: Immune Globulins

Coverage and correct billing for immune globulins (IVIG) are determined by the related Local Coverage Determination (LCD) and its medical necessity criteria. Medical records must document the indication, prior failed or intolerant interventions when routine use is not indicated, and objective clinical response for continued coverage, and must be provided to the Contractor upon request.

"IVIG is covered only for indications specified as covered in the related Local Coverage Determination (LCD) and when medical necessity criteria in that LCD are met."

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