Oncology & Hematology Coding Alert
Check Payers' IVIG Preference
Question: I've heard that we aren't supposed to report immune globulin with J1563 anymore. Would you explain how to code this now?
Pennsylvania Subscriber
Answer: The answer depends on which payer you're dealing with. Some payers still accept the J codes, but starting April 1, 2005, many are asking for Q codes. You need to ask your payer to determine which codes it accepts.
If your payer switched to the Q codes, you should report the following instead of J1563 (Injection, immune globulin, intravenous, 1 g) or J1564 (...10 mg):
Caution: The early pricing lists switched the reimbursements, suggesting the non-lyophilized garnered higher reimbursement. In fact, you should expect higher reimbursement for lyophilized.
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