Reply To: CIDP and Medicare

Some additional Medicare details. My supplement N is with Blueshield and here are their IVIg requirements:
https://www.blueshieldca.com/sites/medicare/documents/PA_CY2016_IVIG_MCweb.pdf

Medical coding for a coverage request can get you denied or thrown into a holding pattern over a request for medical necessity. Here is the coding for IVIg being given to CIDP patients. It includes references to the exact criteria that needs to be specified for coverage and to avoid denials. Most doctors get the coding wrong. You need to help your doctors get it right. Sometimes that might require additional testing:

CPT Jcode – J0850, J1459, J1561, J1568, J2788 – Intravenous Immune Globulin (IVIG)