Billing and Coding: Intravenous Immunoglobulin (IVIG)

Medicare Coverage Database article A56718

Article

Contractor: Palmetto GBA
States (A/B MAC): AL, GA, NC, SC, TN, VA, WV
Effective: Jul 1, 2026
Contractor numbers: 10111, 10112, 10211, 10212, 10311, 10312, 11201, 11202, 11301, 11302, 11401, 11402, 11501, 11502
Official article: A56718 on cms.gov (version 39)

Read the article's coding instructions on CMS — which codes go together, documentation, and frequency limits — before billing. CodeRx lists the codes, not the instructions.

Drug codes in this article

HCPCS Level II drug codes the article lists (other codes it lists are not shown).

Covered ICD-10-CM codes (212)

Diagnosis codes the article lists as supporting medical necessity, grouped as in the article, with CMS's descriptions.

A85.8Other specified viral encephalitis
B08.3Erythema infectiosum [fifth disease]
B20Human immunodeficiency virus [HIV] disease
B25.0Cytomegaloviral pneumonitis
B25.1Cytomegaloviral hepatitis
B25.2Cytomegaloviral pancreatitis
B25.8Other cytomegaloviral diseases
B25.9Cytomegaloviral disease, unspecified
C88.00Waldenstrom macroglobulinemia not having achieved remission
C90.00Multiple myeloma not having achieved remission
C90.02Multiple myeloma in relapse
C91.10Chronic lymphocytic leukemia of B-cell type not having achieved remission
C91.11Chronic lymphocytic leukemia of B-cell type in remission
C91.12Chronic lymphocytic leukemia of B-cell type in relapse
D47.3Essential (hemorrhagic) thrombocythemia
D55.0Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency
D55.1Anemia due to other disorders of glutathione metabolism
D55.21Anemia due to pyruvate kinase deficiency
D55.29Anemia due to other disorders of glycolytic enzymes
D55.3Anemia due to disorders of nucleotide metabolism
D55.8Other anemias due to enzyme disorders
D55.9Anemia due to enzyme disorder, unspecified
D56.0Alpha thalassemia
D56.1Beta thalassemia
D56.2Delta-beta thalassemia
D56.3Thalassemia minor
D56.4Hereditary persistence of fetal hemoglobin [HPFH]
D56.5Hemoglobin E-beta thalassemia
D56.8Other thalassemias
D56.9Thalassemia, unspecified
D57.00Hb-SS disease with crisis, unspecified
D57.01Hb-SS disease with acute chest syndrome
D57.02Hb-SS disease with splenic sequestration
D57.03Hb-SS disease with cerebral vascular involvement
D57.04Hb-SS disease with dactylitis
D57.09Hb-SS disease with crisis with other specified complication
D57.1Sickle-cell disease without crisis
D57.20Sickle-cell/Hb-C disease without crisis
D57.211Sickle-cell/Hb-C disease with acute chest syndrome
D57.212Sickle-cell/Hb-C disease with splenic sequestration
D57.213Sickle-cell/Hb-C disease with cerebral vascular involvement
D57.214Sickle-cell/Hb-C disease with dactylitis
D57.218Sickle-cell/Hb-C disease with crisis with other specified complication
D57.219Sickle-cell/Hb-C disease with crisis, unspecified
D57.3Sickle-cell trait
D57.414Sickle-cell thalassemia, unspecified, with dactylitis
D57.434Sickle-cell thalassemia beta zero with dactylitis
D57.454Sickle-cell thalassemia beta plus with dactylitis
D57.80Other sickle-cell disorders without crisis
D57.811Other sickle-cell disorders with acute chest syndrome
D57.812Other sickle-cell disorders with splenic sequestration
D57.813Other sickle-cell disorders with cerebral vascular involvement
D57.814Other sickle-cell disorders with dactylitis
D57.818Other sickle-cell disorders with crisis with other specified complication
D57.819Other sickle-cell disorders with crisis, unspecified
D58.0Hereditary spherocytosis
D58.1Hereditary elliptocytosis
D58.2Other hemoglobinopathies
D58.8Other specified hereditary hemolytic anemias
D58.9Hereditary hemolytic anemia, unspecified
D59.0Drug-induced autoimmune hemolytic anemia
D59.11Warm autoimmune hemolytic anemia
D59.12Cold autoimmune hemolytic anemia
D59.13Mixed type autoimmune hemolytic anemia
D59.9Acquired hemolytic anemia, unspecified
D61.01Constitutional (pure) red blood cell aplasia
D61.02Shwachman-Diamond syndrome
D61.810Antineoplastic chemotherapy induced pancytopenia
D61.811Other drug-induced pancytopenia
D61.818Other pancytopenia
D69.0Allergic purpura
D69.3Immune thrombocytopenic purpura
D69.41Evans syndrome
D69.42Congenital and hereditary thrombocytopenia purpura
D69.49Other primary thrombocytopenia
D80.0Hereditary hypogammaglobulinemia
D80.1Nonfamilial hypogammaglobulinemia
D80.2Selective deficiency of immunoglobulin A [IgA]
D80.3Selective deficiency of immunoglobulin G [IgG] subclasses
D80.4Selective deficiency of immunoglobulin M [IgM]
D80.5Immunodeficiency with increased immunoglobulin M [IgM]
D80.6Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia
D80.7Transient hypogammaglobulinemia of infancy
D80.8Other immunodeficiencies with predominantly antibody defects
D80.9Immunodeficiency with predominantly antibody defects, unspecified
D81.0Severe combined immunodeficiency [SCID] with reticular dysgenesis
D81.1Severe combined immunodeficiency [SCID] with low T- and B-cell numbers
D81.2Severe combined immunodeficiency [SCID] with low or normal B-cell numbers
D81.4Nezelof's syndrome
D81.5Purine nucleoside phosphorylase [PNP] deficiency
D81.6Major histocompatibility complex class I deficiency
D81.7Major histocompatibility complex class II deficiency
D81.82Activated Phosphoinositide 3-kinase Delta Syndrome [APDS]
D81.89Other combined immunodeficiencies
D81.9Combined immunodeficiency, unspecified
D82.0Wiskott-Aldrich syndrome
D82.1Di George's syndrome
D82.2Immunodeficiency with short-limbed stature
D82.3Immunodeficiency following hereditary defective response to Epstein-Barr virus
D82.4Hyperimmunoglobulin E [IgE] syndrome
D82.8Immunodeficiency associated with other specified major defects
D82.9Immunodeficiency associated with major defect, unspecified
D83.0Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function
D83.1Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
D83.2Common variable immunodeficiency with autoantibodies to B- or T-cells
D83.8Other common variable immunodeficiencies
D83.9Common variable immunodeficiency, unspecified
D84.0Lymphocyte function antigen-1 [LFA-1] defect
D84.1Defects in the complement system
D84.9Immunodeficiency, unspecified
D89.3Immune reconstitution syndrome
D89.810Acute graft-versus-host disease
D89.811Chronic graft-versus-host disease
D89.812Acute on chronic graft-versus-host disease
D89.813Graft-versus-host disease, unspecified
D89.82Autoimmune lymphoproliferative syndrome [ALPS]
D89.831Cytokine release syndrome, grade 1
D89.832Cytokine release syndrome, grade 2
D89.833Cytokine release syndrome, grade 3
D89.834Cytokine release syndrome, grade 4
D89.835Cytokine release syndrome, grade 5
D89.839Cytokine release syndrome, grade unspecified
D89.84IgG4-related disease
D89.89Other specified disorders involving the immune mechanism, not elsewhere classified
D89.9Disorder involving the immune mechanism, unspecified
G04.81Other encephalitis and encephalomyelitis
G11.3Cerebellar ataxia with defective DNA repair
G13.0Paraneoplastic neuromyopathy and neuropathy
G13.1Other systemic atrophy primarily affecting central nervous system in neoplastic disease
G25.82Stiff-man syndrome
G35.ARelapsing-remitting multiple sclerosis
G60.3Idiopathic progressive neuropathy
G61.0Guillain-Barre syndrome
G61.81Chronic inflammatory demyelinating polyneuritis
G61.82Multifocal motor neuropathy
G61.89Other inflammatory polyneuropathies
G62.81Critical illness polyneuropathy
G62.89Other specified polyneuropathies
G64Other disorders of peripheral nervous system
G70.00Myasthenia gravis without (acute) exacerbation
G70.01Myasthenia gravis with (acute) exacerbation
G70.80Lambert-Eaton syndrome, unspecified
G70.81Lambert-Eaton syndrome in disease classified elsewhere
G70.9Myoneural disorder, unspecified
G72.49Other inflammatory and immune myopathies, not elsewhere classified
G72.81Critical illness myopathy
G72.89Other specified myopathies
G73.1Lambert-Eaton syndrome in neoplastic disease
G73.3Myasthenic syndromes in other diseases classified elsewhere
H54.7Unspecified visual loss
L10.0Pemphigus vulgaris
L10.1Pemphigus vegetans
L10.2Pemphigus foliaceous
L10.3Brazilian pemphigus [fogo selvagem]
L10.4Pemphigus erythematosus
L10.5Drug-induced pemphigus
L10.81Paraneoplastic pemphigus
L10.89Other pemphigus
L10.9Pemphigus, unspecified
L12.0Bullous pemphigoid
L12.1Cicatricial pemphigoid
L12.8Other pemphigoid
L12.9Pemphigoid, unspecified
L13.8Other specified bullous disorders
L95.0Livedoid vasculitis
L95.9Vasculitis limited to the skin, unspecified
M30.3Mucocutaneous lymph node syndrome [Kawasaki]
M33.00Juvenile dermatomyositis, organ involvement unspecified
M33.01Juvenile dermatomyositis with respiratory involvement
M33.02Juvenile dermatomyositis with myopathy
M33.03Juvenile dermatomyositis without myopathy
M33.09Juvenile dermatomyositis with other organ involvement
M33.10Other dermatomyositis, organ involvement unspecified
M33.11Other dermatomyositis with respiratory involvement
M33.12Other dermatomyositis with myopathy
M33.13Other dermatomyositis without myopathy
M33.19Other dermatomyositis with other organ involvement
M33.20Polymyositis, organ involvement unspecified
M33.21Polymyositis with respiratory involvement
M33.22Polymyositis with myopathy
M33.29Polymyositis with other organ involvement
M33.90Dermatopolymyositis, unspecified, organ involvement unspecified
M33.91Dermatopolymyositis, unspecified with respiratory involvement
M33.92Dermatopolymyositis, unspecified with myopathy
M33.93Dermatopolymyositis, unspecified without myopathy
M33.99Dermatopolymyositis, unspecified with other organ involvement
M36.0Dermato(poly)myositis in neoplastic disease
M60.80Other myositis, unspecified site
R78.81Bacteremia
T86.10Unspecified complication of kidney transplant
T86.11Kidney transplant rejection
T86.12Kidney transplant failure
T86.13Kidney transplant infection
T86.19Other complication of kidney transplant
T86.21Heart transplant rejection
T86.22Heart transplant failure
T86.23Heart transplant infection
T86.298Other complications of heart transplant
T86.5Complications of stem cell transplant
Z41.8Encounter for other procedures for purposes other than remedying health state
Z48.21Encounter for aftercare following heart transplant
Z48.22Encounter for aftercare following kidney transplant
Z48.23Encounter for aftercare following liver transplant
Z48.24Encounter for aftercare following lung transplant
Z48.280Encounter for aftercare following heart-lung transplant
Z48.288Encounter for aftercare following multiple organ transplant
Z48.290Encounter for aftercare following bone marrow transplant
Z48.298Encounter for aftercare following other organ transplant
Z94.0Kidney transplant status
Z94.1Heart transplant status
Z94.81Bone marrow transplant status
Z94.84Stem cells transplant status

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