Local Coverage Article Response to Comments

Response to Comments: Immune Globulin Intravenous (IVIg)


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Article ID
Article Title
Response to Comments: Immune Globulin Intravenous (IVIg)
Article Type
Response to Comments
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Noridian’s response to provider recommendations (for comment period ending 04/10/2015):

Response To Comments

1One commenter suggested that it might be better to say” lymphoproliferative disease” or” lymphoproliferative diseases, including CLL” rather than using the term “CLL”. Occasionally, patients with other kinds of lymphoma developed significant hypogammaglobulinemia and infection.The ICD-9 diagnosis coding for lymphomas and related disorders was developed long before current lymphoma classifications using modern laboratory methods. Persons with these disorders who also have hypogammaglobulinemia and are prone to infections, should receive IVIG. Claims for IVIG for these patients might appropriately be coded with an ICD-9 code that describes their lymphoma AND an appropriate ICD-9 code for hypogammaglobulinemia such as 279.00 (hypogammaglobulinemia, unspecified). The presence of that latter code would allow payment under this LCD as issued in draft; however, the LCD finalized after ICD-10 implementation and the greater granularity of ICD-10 diagnosis codes provides singular diagnoses for this indication.
2One commenter urged the expansion of “acceptable off-label uses for intravenous immune globulin (IVIg) in rare patient populations or in rare individual patient clinical scenarios” to include autoimmune retinopathy. Numerous references were also appended.We agree that many individuals with autoimmune retinopathy may benefit from infusions of intravenous immune globulins. The difficulty with regard to this policy is that there is no precise coding for that condition and the codes likely to be used are extremely non-specific. We have added language in the policy for this condition, but coverage will be handled as an “individual consideration”.

Associated Documents

Related Local Coverage Documents
L34074 - Immune Globulin Intravenous (IVIg)
Related National Coverage Documents
Public Versions
Updated On Effective Dates Status
09/01/2015 11/07/2015 - N/A Currently in Effect You are here


  • Immune
  • Globulin
  • Intravenous
  • IVIg