Summary & Overview
CPT 90291: Cytomegalovirus Immune Globulin (CMV–IgIV) Infusion
CPT code 90291 denotes administration of Cytomegalovirus immune globulin (CMV–IgIV), a pooled human immunoglobulin product used to provide passive immunity against CMV. This code is relevant nationally for hospitals, infusion centers, transplant programs, and specialty clinics that manage immunocompromised patients at risk for CMV infection. Claims for immune globulin products carry clinical and billing complexity because dosing, indication, and site of service affect utilization and payer policies.
Key payers commonly involved in coverage decisions include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for CMV–IgIV use, typical sites of service, and what to expect in payer coverage patterns. The publication summarizes benchmarks where available, highlights typical billing considerations such as common modifiers, and outlines policy and coding issues that influence claims processing and reimbursement. This resource is intended to help coding, billing, and clinical teams understand the role of CPT code 90291 in immunoglobulin therapy workflows and payer interactions, and to provide a concise reference to support accurate claim submission and administrative planning.
Billing Code Overview
CPT code 90291 describes administration of Cytomegalovirus immune globulin (CMV–IgIV), a pooled human immunoglobulin preparation used to provide passive immunity against cytomegalovirus (CMV). The product is derived from adult plasma and contains complex immunoglobulin proteins intended to neutralize or modify CMV infection risk.
Service type: Intravenous immune globulin therapy for CMV prophylaxis or treatment.
Typical site of service: Hospital outpatient infusion center, inpatient hospital setting, or specialized infusion clinic.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a solid-organ transplant recipient (for example, lung or liver transplant) who receives intravenous Cytomegalovirus immune globulin (CMV–IgIV) as part of prophylaxis or early treatment to prevent or mitigate cytomegalovirus infection. The clinical workflow begins with identification of CMV serostatus (donor and recipient), assessment of risk (D+/R- highest risk), and an order for passive immunoprophylaxis when indicated. The patient usually presents to an outpatient infusion center, hospital outpatient department, or inpatient ward. Prior to infusion, nursing documents informed consent, verifies identity and allergies, and checks baseline vital signs and intravenous access. Pharmacy compounds or dispenses the pooled immunoglobulin product per manufacturer instructions; the product is labeled and may require the JW modifier if discarded partial doses are billed. During infusion, nursing monitors for infusion reactions and documents administration time, lot number, and volume infused. Post-infusion, vital signs and adverse event monitoring continue; documentation includes clinical indication, dose, route, lot numbers, and any infusion-related events. Billing is submitted for the administered immune globulin using 90291 with appropriate modifiers as indicated by payor rules and clinical circumstances.
Coding Specifications
| Modifier | Description | When to Use |
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