Vivaglobin, pump, tubing & ancillaries are reimbursed by the DMERC
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Medicare B Durable Medical Equipment Regional Carriers Approves Subcutaneous Immune Globulin to External Infusion Pumps LCD
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Vivaglobin®, pump, tubing & ancillaries are reimbursed by the DMERC
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Durable Medical Equipment Regional Carriers
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CMS establishes new code and separate therapeutic class “Injection, Immune Globulin, Subcutaneous”
Coverage under the DMERC ensures that in addition to Vivaglobin, the pump, tubing and ancillaries are also reimbursed by the DMERC. This will give patients with Medicare B the option to infuse Vivaglobin in the privacy of their homes.
The IVIG codes, J1566 and J1567 must not be used and do not apply to the coverage bulletin. IVIG is covered under a separate benefit category in which the infusion pump and ancillaries are not covered for administration. ZLB Behring anticipates the assignment of a unique J-Code for Vivaglobin® for use in CY 2007.
In the interim, Code J7799 (not otherwise classified drugs, other than inhalation drugs, administered through DME) is the recommended code for Vivaglobin® by the DMERC.
Physicians' offices must bill the local Medicare B carrier and not the DMERC. Code J3590, Biologic not yet classified, is recommended pending the assignment of the unique J Code.
For effective coverage date and coding information for Vivaglobin, the pump and ancillaries, please refer to
DMERC bulletin of 6/1/2006
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Reimbursement Alert Online August 2006
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