Intravenous Immunoglobulin (IVIG)

IVIG is covered for a broad set of immunodeficiency, hematologic, neurologic, autoimmune, and transplant-related indications, including replacement therapy for primary humoral immunodeficiencies, ITP when rapid platelet increase is required, Kawasaki disease with aspirin, and prophylaxis after bone marrow transplant (first 100 days). Specific time- or lab-based limits are noted for some indications (e.g., GBS within 2 weeks of onset; HIV-infected children with CD4 ≈200–400), and several entries (CIDP, autoimmune myopathies, mucocutaneous blistering diseases) reference additional diagnostic or external CMS criteria requiring case-level review.

"IVIG is covered to replace or boost immunoglobulin G (IgG) in primary immunodeficiency syndromes associated with defects in humoral immunity."

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