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LCD for Immune Globulin Intravenous (IVIg) (L34074)
See related Articles:
A54643-Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
A54647-Response to Comments: Immune Globulin Intravenous (IVIg)
A54662-Billing and Coding: Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home – Medicare Benefit Policy Manual, Chapter 15, 50.6
A57194-Billing and Coding: Immune Globulin Intravenous (IVIg)

Contractor Information

Contractor Name: Noridian Healthcare Solutions, LLC - Full list of policies of this Medicare Contractor

Contractor Number: 03302

Contractor Type: MAC B

LCD Information

LCD ID Number: L34074 Status: A-Approved

LCD Title: Immune Globulin Intravenous (IVIg)

Geographic Jurisdiction: North Dakota Other Jurisdictions

Original Determination Effective Date: 10/01/2015

Original Determination Ending Date:

Revision Effective Date: 02/01/2020

Revision End Date:

CMS National Coverage Policy:

Title XVIII of the Social security Act; Section 1862(a)(1)(A) section allows coverage and payment for only those services that are considered to be reasonable and necessary.

Title XVIII of the Social Security Act; Section 1833(e). This section prohibits Medicare payment for any claim, which lacks the necessary information to process the claim.

CMS Manual, Pub.100-2, Chapter 15, section 50.4 and section 50.4.2. This section addresses coverage of drugs and biologicals.

CMS Manual, Pub.100-3, Chapter 1, Section 250.3. This section describes coverage for IVIg for treatment of Autoimmune Mucocutaneous Blistering Diseases.

CMS Manual, Pub. 100-2, Chapter 15, Section 50.6. This section describes coverage of IVIg for the treatment of Primary Autoimmune Deficiency Disease in the home.

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07/17/2024 07:19:26

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