IgG ICD-10 codes for policy.docx

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ICD-10-CM Codes associated with Immune globulin therapy – Effective 10/1/2015

ICD-10-CM Codes ICD-10-CM codes listed below are for informational purposes only, and do not guarantee member coverage or provider reimbursement.The list may not be all-inclusive.

ICD-10-CM Code(s) ICD-10-CM Code description(s) B20 Human immunodeficiency virus [HIV] disease

C90.00-C90.02 Multiple myeloma

C91.10-C91.12 Chronic lymphocytic leukemia of B-cell type

C91.Z0-C91.92 Other and unspecified lymphoid leukemia

C95.10-C95.12 Chronic leukemia of unspecified cell type

D59.0 Drug-induced autoimmune hemolytic anemia

D59.1 Other autoimmune hemolytic anemias

D69.3 Immune thrombocytopenic purpura

D69.41 Evans syndrome

D69.51-D69.59 Secondary thrombocytopenia

D80.0 Hereditary hypogammaglobulinemia

D80.1 Nonfamilial hypogammaglobulinemia

D80.3 Selective deficiency of immunoglobulin G [IgG] subclasses

D80.4 Selective deficiency of immunoglobulin M [IgM]

D80.5 Immunodeficiency with increased immunoglobulin M [IgM]

D80.7 Transient hypogammaglobulinemia of infancy

D81.0-D81.2 Severe combined immunodeficiency [SCID]

D81.6 Major histocompatibility complex class I deficiency

D81.7 Major histocompatibility complex class II deficiency

D81.89 Other combined immunodeficiencies

D81.9 Combined immunodeficiency, unspecified

D82.0-D82.9 Immunodeficiency associated with other major defects

D83.0, D83.2-D83.9 Common variable immunodeficiency

D84.0 Lymphocyte function antigen-1 [LFA-1] defect

D84.1 Defects in the complement system

D89.3 Immune reconstitution syndrome

D89.810, D89.812, D89.89 Graft-versus-host disease

G61.0, G61.81, G61.89 Inflammatory polyneuropathy

G62.89 Other specified polyneuropathies

G64 Other disorders of peripheral nervous system

G65.0 Sequelae of Guillain-Barre syndrome

G70.01 Myasthenia gravis with (acute) exacerbation

G70.80, G70.81 Lambert-Eaton syndrome

G71.2 Congenital myopathies

G71.3 Mitochondrial myopathy, not elsewhere classified

G71.8 Other primary disorders of muscles

G71.9 Primary disorder of muscle, unspecified

G72.0 Drug-induced myopathy

G72.1 Alcoholic myopathy

G72.81 Critical illness myopathy

G72.89 Other specified myopathies

G72.9 Myopathy, unspecified

G73.1-G37.7 Disorders of myoneural junction and muscle in diseases classified elsewhere

L10.0-L10.9 Pemphigus

L12.0, L12.1, L12.8, L12.9 Pemphigoid

L13.0-L14 Other bullous disorders & bullous disorders in diseases classified elsewhere

M33.00-M33.99 Dermatopolymyositis

IgG ICD-10 codes for policy.docx

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M35.9 Systemic involvement of connective tissue, unspecified

M36.0 Dermato(poly)myositis in neoplastic disease

Z48.290 Encounter for aftercare following bone marrow transplant

Z94.81 Bone marrow transplant status