Medicare expands coverage for intravenous Ig treatment of PI in the home

On July 12, the Centers for Medicaid and Medicare Services (CMS) issued a Change Request (11295) – Update to Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home.

The Immune Deficiency Foundation (IDF) has been successful in advocating to the CMS for 10 additional primary immune (PI) deficiency diagnoses codes, expanding the coverage of home immunoglobulin (Ig) replacement therapy. The newly covered ICD-10 codes become effective Aug.13.

The ten new codes are:

  • G11.3 Cerebellar ataxia with defective DNA repair
  • D80.2 Selective deficiency of immunoglobulin A [IgA]
  • D80.3 Selective deficiency of immunoglobulin G [IgG] subclasses
  • D80.4 Selective deficiency of immunoglobulin M [IgM]
  • D80.6 Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia
  • D80.7 Transient hypogammaglobulinemia of infancy
  • D81.5 Purine nucleoside phosphorylase [PNP] deficiency
  • D82.1 Di George's syndrome
  • D82.4 Hyperimmunoglobulin E [IgE] syndrome
  • D83.1 Common variable immunodeficiency with predominant immunoregulatory T-cell disorders

In their announcement, the IDF stated, “These code changes will greatly expand the number of people with PI who will have access to Ig replacement therapy in the home and will benefit current and future Medicare beneficiaries in the Primary Immune Deficiency community.”

The Advocacy Council of ACAAI – we’ve got you covered!

Advocacy Issue: 
Billing, Coding & Payments