Have the payable diagnoses for IVIG and Rituximab changed? I don’t see all of the previously payable diagnoses in the applicable drug LCDs and articles.
No, we’ve moved coverage for those drugs from articles to new LCDs, which only include off-label indications and diagnoses. These are the coding articles attached to the new LCDs: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG); Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars.
Please note, our edits still allow FDA labeled and Compendia covered diagnoses, as listed in the previous articles. For complete up to date coverage refer to the LCD for Drugs and Biologicals, Coverage of, for Label and Off-Label Uses, which includes the description of how coverage is determined for these drugs.
Note: Coverage for additional drug codes will be moved from articles to new LCD’s in the future.