Intravenous Immune Globulin
L35891
IVIG is covered for multiple primary and secondary antibody‑deficiency conditions (e.g., CVID, congenital agammaglobulinemia, selected post‑HSCT patients, CLL with IgG <600 mg/dL), specified pediatric HIV cases, several neurologic and autoimmune disorders when diagnostic and prior‑therapy criteria are met, and certain drug‑induced hypogammaglobulinemia. Coverage requires laboratory evidence of IgG deficiency plus demonstrated inability to mount antibody responses (for CVID), detailed diagnostic testing and documentation of objective response and prior therapy failures where applicable, and dosing/frequency must follow indicated regimens with short‑term use required for some indications (e.g., autoimmune blistering diseases).
"IVIG is covered for primary humoral immunodeficiency syndromes (e."
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