CPT 90384 Rho(D) Immune Globulin Reimbursement | OpenPayer

Summary & Overview

CPT 90384: Rho(D) (Rhesus D) Immune Globulin, Full Dose

CPT code 90384 identifies a full dose of human Rho(D) immune globulin used to prevent Rhesus disease (hemolytic disease of the newborn) by providing passive anti-Rho(D) antibodies. This prophylactic biologic is clinically important in obstetrics to reduce alloimmunization after potential fetal-maternal blood exposure. Nationally, appropriate use of 90384 affects maternal and neonatal outcomes and drives utilization in outpatient obstetric and infusion settings.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings for 90384, plus benchmarking and payer policy considerations where data is available. The publication highlights coding and billing implications, typical sites of service, and what to expect from major payers regarding coverage patterns. Data not available in the input is noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare90384CPTRho(D) immune globulinhemolytic disease of the newbornobstetricsprophylaxisinfusion therapyimmunoglobulinmaternal health

Billing Code Overview

CPT code 90384 describes a full dose of human Rho(D) immune globulin derived from plasma of immunized healthy donors. Rho(D) (Rhesus D) immune globulin is a preparation of immunoglobulin used to provide passive immunity and to prevent Rhesus disease (hemolytic disease of the newborn) by neutralizing Rhesus D antigen exposure in at-risk individuals.

Service Type: Immune globulin administration for Rho(D) prophylaxis

Typical Site of Service: Outpatient clinics, obstetrics/gynecology clinics, hospital outpatient departments, and infusion centers

Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.

Clinical & Coding Specifications

Clinical Context

A 28-year-old Rh-negative pregnant woman presents at 28 weeks' gestation after routine prenatal antibody screening is negative for anti-D but reports a recent episode of abdominal trauma. The obstetric clinician documents risk of fetomaternal hemorrhage and orders human Rho(D) immune globulin prophylaxis to prevent maternal sensitization to the rhesus D antigen. The patient receives a full-dose intramuscular administration of 90384 (Rho(D) immune globulin) in the outpatient obstetrics clinic. The clinical workflow includes informed consent, verification of maternal Rh-negative status and current antibody screen, assessment for any prior Rho(D) immune globulin administration or transfusion history, preparation and administration of the medication, post-injection observation for anaphylaxis or local reaction, and documentation of lot number, dose, administration site, and the indication in the medical record.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure	Use when an E/M visit is performed and documented on the same day as `90384` for a separate reason (e.g., assessment after trauma prompting Rho(D) administration).

CPT 90393: Vaccine Immune Globulin for Smallpox Prophylaxis

CPT-90381-RSV-MONOCLONAL-ANTIBODY-IMMUNIZATION-1ML

CPT 90381: RSV Monoclonal Antibody Intramuscular Immunization, 1 mL

CPT-90399-IMMUNE-GLOBULIN-ADMINISTRATION-UNLISTED

CPT 90399: Immune Globulin Administration, Unlisted

CPT-90284-SUBCUTANEOUS-IMMUNOGLOBULIN-INJECTION-SCIG-IGSC

CPT 90284: Subcutaneous Immunoglobulin Injection (SCIg/IgSC)

CPT-90380-RSV-MONOCLONAL-ANTIBODY-IMMUNIZATION-0-5ML

CPT 90380: RSV Monoclonal Antibody, 0.5 mL Intramuscular Dose

CPT-90396-VARICELLA-ZOSTER-IMMUNE-GLOBULIN-IMMUNOPROPHYLAXIS

CPT 90396: Intramuscular Varicella–Zoster Immune Globulin Supply

CPT-90288-BOTULISM-IMMUNE-GLOBULIN-INTRAVENOUS

CPT 90288: Botulism Immune Globulin Intravenous

CPT-90389-TETANUS-IMMUNOGLOBULIN-PASSIVE-IMMUNIZATION

CPT 90389: Tetanus Immunoglobulin for Passive Immunization

CPT-90371-HEPATITIS-B-IMMUNOGLOBULIN-HBIG

CPT 90371: Hepatitis B Immunoglobulin (HBIg)

CPT-90283-IMMUNOGLOBULIN-PASSIVE-IMMUNITY

CPT 90283: Immunoglobulin for Passive Immunity

Showing 1–10 of 21

Taxonomy Code	Specialty	Notes
`207V00000X`	Obstetrics & Gynecology	Obstetricians commonly order and administer `90384` for prenatal prophylaxis and postpartum use.
`163W00000X`	Maternal-Fetal Medicine	High-risk pregnancy specialists manage alloimmunization risk and coordinate Rho(D) immune globulin prophylaxis.
`193200000X`	Family Medicine	Family physicians and family medicine obstetric providers administer routine prenatal injections including Rho(D).
`363A00000X`	Nurse Midwife	Certified nurse-midwives provide prenatal care and administer Rho(D) immune globulin in outpatient settings.
`284N00000X`	Hematology	Hematologists may be involved in management when significant fetomaternal hemorrhage or alloimmunization is detected.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O36.011`	Maternal care for anti-D antibodies, first trimester	Indicates pregnancy with maternal anti-D antibodies; relates to monitoring and potential prophylaxis decisions around `90384`.
`O36.012`	Maternal care for anti-D antibodies, second trimester	Reflects midpregnancy care for alloimmunization risk requiring consideration of Rho(D) immune globulin.
`O36.013`	Maternal care for anti-D antibodies, third trimester	Relevant to late-pregnancy surveillance and timing of `90384` administration (e.g., at 28 weeks or postpartum).
`O36.8XX0`	Maternal care for other known or suspected fetal problems, unspecified trimester	Used when specific fetal-maternal conditions prompt evaluation and prophylaxis with `90384`.
`Z30.09`	Encounter for other general counseling and advice on contraception	Included when family planning counseling occurs in the same visit; administrative relevance when multiple services are billed alongside `90384`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Performed before or at time of `90384` administration to obtain maternal blood for antibody screen and Kleihauer or quantitative fetomaternal hemorrhage testing.
`86900`	Antibody identification; serum	Used for maternal antibody identification if the screen is positive prior to considering `90384` administration.
`86850`	Antibody screen (eg, Rh)	Routine prenatal screening that determines need for `90384` when maternal Rh status and antibodies are assessed.
`88172`	Cytology automated thin layer prep, screening	Not directly related to `90384` but commonly performed in obstetric clinics; included here as a clinic ancillary code if documentation includes multiple services.
`99070`	Supplies and materials (except spectacles), provided by physician over and above those usually included with the office visit	Used when billing for additional supplies specifically associated with administration of `90384` not included in the standard visit.

OpenPayer