Immune Globulin Intravenous (IVIg)
L34314
IVIg is covered for a range of FDA-approved and certain off-label immune and neurologic indications when diagnosis is well-documented and there is clinical necessity (e.g., ITP in pregnancy with platelet thresholds, Guillain-Barré, Myasthenia Gravis, CIDP with diagnostic criteria met, Kawasaki disease, select transplant and immunodeficiency indications). Coverage requires objective diagnostic evidence and documentation (EMG/EDX, CSF, IgG levels, specialist consultation for CIDP), documentation of prior treatment failure or contraindication when applicable, quantitative monitoring of benefit, and periodic attempts to taper or discontinue therapy when stable; several neurologic conditions (epilepsy, ALS, paraneoplastic syndromes, undiagnosed neuropathy, and malignancies without neurologic link) are explicitly non-reimbursable.
"IVIg is covered for pregnant women with idiopathic thrombocytopenic purpura (ITP) who have a prior infant with autoimmune thrombocytopenia, a platelet count <75,000/mm3 during the current pregnancy..."