LCD Reference Article Response To Comments Article

Response to Comments: Off-Label Use of Intravenous Immune Globulin (IVIG)

A59251

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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General Information

Source Article ID
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Article ID
A59251
Original ICD-9 Article ID
Not Applicable
Article Title
Response to Comments: Off-Label Use of Intravenous Immune Globulin (IVIG)
Article Type
Response to Comments
Original Effective Date
11/01/2022
Revision Effective Date
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Revision Ending Date
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Retirement Date
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CMS National Coverage Policy

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Article Guidance

Article Text

As an important part of Medicare Local Coverage Determination (LCD) development, National Government Services solicits comments from the provider community and from members of the public who may be affected by or interested in our LCDs. The purpose of the advice and comment process is to gain the expertise and experience of those commenting.

We would like to thank those who suggested changes to the Off-Label Use of Intravenous Immune Globulin (IVIG) Local Coverage Determination. The official notice period for the final LCD begins on September 15 2022, and the final determination will become effective on November 1, 2022.

Response To Comments

Number Comment Response
1

One rheumatologist, due to the limited treatment options for patients with significant lung or GI involvement for patients with a diagnosis of systemic sclerosis, requested coverage for the condition of systemic sclerosis.

Based on the paucity of evidence, NGS will not provide blanket coverage for systemic sclerosis; however, we will individually consider claims upon appeal.

2

Another rheumatologist requested coverage for immune mediated necrotizing myositis, a subset of polymyositis, for patients who become refractory to standard treatment options.

Based on the review of evidence, NGS will provide coverage for immune mediated necrotizing myositis.

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Revision History Information

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related National Coverage Documents
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Public Versions
Updated On Effective Dates Status
09/07/2022 11/01/2022 - N/A Currently in Effect You are here

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