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Official Description

Services, supplies and accessories used in the home for the administration of intravenous immune globulin (ivig)
Short Descr Home ivig, services/supplies
Coverage Special coverage instructions apply
Pricing Indicator(s) 57 – Other carrier priced
MPI A – Not applicable, as HCPCS priced under one methodology
Processing Note PL 112-242.
BETOS O1E – Other drugs
TOS Code(s) 9 – Other medical items or services
Added Date 4/1/2014
Status Code Excluded from Physician Fee Schedule by Regulation
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
KX Requirements specified in the medical policy have been met
GW Service not related to the hospice patient's terminal condition
JB Administered subcutaneously
GA Waiver of liability statement issued as required by payer policy, individual case
CR Catastrophe/disaster related
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
EY No physician or other licensed health care provider order for this item or service
JZ Zero drug amount discarded/not administered to any patient
Date
Action
Notes
2024-01-01 Changed Long Description change.
2023-07-01 Changed Code changed. Change in short description.
2014-04-01 Added Code added 4/1/2014
2014-01-01 Added Added
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