[CIS PIDD] [cis-pidd] medicare IVIG question

[Richard Wasserman]

CVID patients are at risk for lymphoma. Do you know that they didn't have
CVID before they were treated? If their Ig levels support CVID, I'd use
279.06.
Richard Wasserman
Dallas


On Tue, Nov 26, 2013 at 2:57 PM, James L. Friedlander, M.D. <
jfriedlander at allergyasthmaimm.com> wrote:


> I have several Medicare patients with B cell lymphoma treated with

> rituximab that develop recurrent sinopulmonary infections during/after

> treatment, along with significant hypogammaglobulinemia and non-protective

> antibody titers.  Medicare is requiring one of the diagnoses listed below

> before they will approve treatment with immune replacement.

>

> 279.04 Congenital hypogammaglobulinemia

> 279.05 Immunodeficiency with increased IgM

> 279.06 CVID

> 279.12 WAS

> 279.2 Combined ID

>

> I would argue that none of these are correct, as these patients clearly

> have drug-induced immunodeficiency.  Listing hypogammaglobulinemia alone or

> in combination with antibody deficiency for diagnosis codes does not work

> for Medicare, but this has worked for some private insurance companies.

>

> Anyone else come across this issue?  Thanks.

>

> Jim Friedlander

> Omaha, NE

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-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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