CPT 90283: Immunoglobulin for Passive Immunity
CPT code 90283 represents immunoglobulin products used to provide passive immunity against infections. Immunoglobulin therapies are clinically important for prophylaxis and treatment of immune deficiencies and certain infectious exposures; nationally, these services contribute to outpatient infusion volumes and are central to managing patients who require antibody-based protection. Coverage and payment policies for immunoglobulin administration affect hospital outpatient departments, infusion centers, clinics, and physician offices across payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for immunoglobulin use, common sites of service, and the implications for billing and claims processing. The publication summarizes benchmark considerations, typical payer coverage patterns, relevant billing modifiers listed in input data, and where data are not available.
This summary also outlines what to expect in the full publication: coding and billing guidance tied to CPT code 90283, payer-specific coverage considerations, and operational notes for outpatient administration settings. Data not available in the input are identified where applicable.
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Billing Code Overview
CPT code 90283 describes immunoglobulin, complex proteins produced by certain cells that provide passive immunity and protect the body from infections. The code applies to services involving immunoglobulin preparation or administration intended to confer passive immune protection.
Service Type: Immune globulin therapy / passive immunization
Typical Site of Service: Outpatient infusion centers, hospital outpatient departments, clinic settings, or physician offices where immunoglobulin products are prepared and administered
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult or pediatric patient receiving immunoglobulin therapy for passive immunity or immune modulation. Common indications include primary immunodeficiency disorders, certain autoimmune or inflammatory conditions (e.g., immune thrombocytopenia, Guillain-Barré syndrome), or post-exposure prophylaxis when indicated. The clinical workflow begins with a physician evaluation documenting indication, dose calculation (often by weight), and informed consent. Pharmacy prepares the immunoglobulin product and documents lot numbers and expiration. Nursing administers the product intravenously or subcutaneously per protocol, monitors vital signs and infusion tolerance, and documents start/stop times and any adverse reactions. Post-infusion observation and follow-up instructions are provided, and billing staff submits the appropriate code for the immunoglobulin product and any administration services or supplies as separate line items when applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Not typically appended; use per payer rules when no specific modifier applies. |
22 | Increased procedural services | When work required to prepare or manage the immunoglobulin is substantially greater than typical (rare for product codes). |
26 | Professional component | Use when billing only the professional interpretation/component associated with services tied to administration (uncommon for product code). |
52 | Reduced services | When the full dose or service was partially rendered (e.g., infusion discontinued early by patient request). |
53 | Discontinued procedure | When the infusion is terminated due to a complication or medical necessity before completion. |
59 is not in the provided list | Data not available in the input | Data not available in the input |
62 | Two surgeons | When two providers of the same specialty are required (rare for immunoglobulin product billing). |
78 | Return to OR for related procedure by same physician | Not typically applicable to immunoglobulin product billing. |
80 | Assistant at surgery | Not applicable for infusion product billing. |
82 | Assistant surgeon (when qualified resident not available) | Not applicable for infusion product billing. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Not applicable for immunoglobulin product billing. |
CO | Charge capture modifier for specific payers (payer-specific) | Use per payer instructions when required for coordination of benefits or claim adjudication. |
CQ | Service furnished by a registered nurse under the direction of a certified nurse-midwife | Use when relevant to the billing rules that require this designation. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Not applicable to immunoglobulin product billing. |
QX | CRNA service with medical direction by a physician | Not applicable to immunoglobulin product billing. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
208000000X | Allergy & Immunology | Specialists who diagnose and manage primary immunodeficiencies and direct immunoglobulin therapy. |
207RC0000X | Internal Medicine | Hospitalists and internists managing medical indications and ordering immunoglobulin. |
207Q00000X | Pediatrics | Pediatricians treating children needing immunoglobulin for immunodeficiency or inflammatory conditions. |
261QM0800X | Nursing — Infusion Therapy | Registered nurses specialized in infusion delivery and monitoring of immunoglobulin infusions. |
3336C0003X | Pharmacy | Clinical pharmacists involved in product selection, dosing, and preparation of immunoglobulin products. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D80.0 | Hereditary hypogammaglobulinemia | Indication for immunoglobulin replacement therapy to prevent recurrent infections. |
D80.1 | Nonfamilial hypogammaglobulinemia | Common indication for periodic immunoglobulin infusions. |
D80.2 | Selective deficiency of immunoglobulin A | May require immunoglobulin in select clinical situations, particularly with recurrent infections. |
G61.0 | Guillain-Barré syndrome | Immunoglobulin used as immunomodulatory therapy for acute inflammatory demyelinating polyneuropathy. |
D69.3 | Idiopathic thrombocytopenic purpura (ITP) | Intravenous immunoglobulin is used to raise platelet counts in acute settings. |
M35.9 | Systemic involvement of connective tissue disorder, unspecified | Some autoimmune connective tissue diseases are treated with immunoglobulin for refractory inflammatory activity. |
A82.9 | Rabies, unspecified | Immunoglobulin used as part of rabies post-exposure prophylaxis in conjunction with vaccine when indicated. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | Common administration code used when intravenous immunoglobulin infusion is the primary service and billed separately from the product. |
96366 | Intravenous infusion, each additional hour (List separately in addition to code for primary service) | Used when infusion of immunoglobulin extends beyond the first hour. |
96367 | Additional sequential infusion, up to 1 hour (for second infusion on same day) | Used for a separate infusion episode on the same day if clinically indicated. |
96377 | Intravenous infusion, therapeutic, prophylactic, or diagnostic; each additional sequential infusion of a new drug/substance (List separately in addition to code for primary service) | Used when multiple different biologic products are administered sequentially. |
36415 | Collection of venous blood by venipuncture | Commonly performed before infusion for baseline labs (e.g., Ig levels, CBC) and monitoring. |