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HCPCS J1556: Injection, Immune Globulin (BIVIGAM), 500 mg

HCPCS Level II code J1556 designates a 500 mg unit of BIVIGAM, an intravenous immune globulin product. This code is used to report the drug component for patients receiving immune globulin therapy and is relevant to hospitals, infusion centers, and physician practices nationwide. Immune globulin therapies are used across immunology, neurology, hematology, and infectious disease indications, making accurate coding important for clinical documentation, payer adjudication, and national utilization monitoring.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national-level context for the code, including how it maps to infusion service delivery, common sites of service, and the payer landscape influencing coverage and billing workflows. The publication summarizes benchmarks where available, highlights relevant policy and billing considerations affecting reimbursement and claims processing, and provides clinical context for use of BIVIGAM in infusion settings.

Content is intended for coders, billing managers, clinicians involved in infusion therapy, and policy analysts seeking a concise reference on HCPCS Level II code J1556 and its role in reporting immune globulin administration nationally.

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Billing Code Overview

HCPCS Level II code J1556 represents an injection of immune globulin (BIVIGAM) supplied in a 500 mg dosage unit. This code denotes the drug product and is used to report administration of intravenous immune globulin when BIVIGAM is the product provided.

Service type: Drug administration (intravenous immune globulin product)

Typical site of service: Hospital outpatient infusion suite, physician office infusion center, or outpatient infusion clinic

Data not available in the input.

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HCPCS J1556: Injection, Immune Globulin (BIVIGAM), 500 mg

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Get alerted when payer policies referencing J1556 are released or updated.

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Billing Code Overview

Service type: Drug administration (intravenous immune globulin product)

Typical site of service: Hospital outpatient infusion suite, physician office infusion center, or outpatient infusion clinic

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with documented primary immunodeficiency presents to an ambulatory infusion center for administration of intravenous immune globulin, billed as J1556 (injection, immune globulin (Bivigam), 500 mg). The patient has prior history of recurrent sinopulmonary infections and laboratory confirmation of hypogammaglobulinemia. The clinical workflow includes verification of physician order, pre-infusion vitals and allergy screening by a registered nurse, review of premedication need (acetaminophen or antihistamine) and necessary consent, placement of intravenous access, reconstitution/dosing of Bivigam to the prescribed total grams, administration via infusion pump with incremental rate escalation under nursing monitoring for infusion-related reactions, documentation of lot number and vial discard information, and post-infusion observation before discharge. Billing captures the HCPCS Level II code J1556 per 500 mg unit supplied, with applicable modifiers for payment or situational reporting. Typical sites of service include hospital outpatient infusion centers, freestanding infusion clinics, and physician office infusion suites. Common concurrent services in the encounter include IV catheter insertion and monitoring by nursing staff, but drug administration is reported via the HCPCS code rather than an infusion CPT for drug itself.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Used when no special reporting modifier applies to the service.
`11`	Professional component	Applied when reporting the professional component if applicable to associated services (rare for drug J-codes).
`22`	Increased procedural services	When work or resource use is substantially greater than typical for associated services (e.g., prolonged monitoring for severe reaction).
`52`	Reduced services	When the service provided is partially reduced or eliminated at physician/provider discretion.
`53`	Discontinued procedure	When infusion is started but discontinued due to patient reaction or other contraindication.
`62`	Two surgeons	If two qualified professionals share responsibility for unrelated aspects of the encounter (uncommon for drug administration).
`78`	Unplanned return to OR by same physician following initial procedure	Rarely applicable; included when an infusion-related complication requires immediate return to operative care.
`80`	Assistant surgeon	When an assistant surgeon is involved in a related procedural service (not typical for medication infusion).
`JW`	Drug discarded/expired	When a portion of a single-use vial is discarded and must be reported for wastage not billed to the patient.
`JZ`	No drug wastage	When no part of the drug vial is discarded.
`KX`	Requirements specified in the medical policy are met	When treatment meets payer-specific medical necessity documentation rules.
`QK`	Monoclonal antibody administration — single infusion/initial administration (not specific to IG but used in some payer rules)	If a payer requires this modifier for initial or single-dose administrative reporting.
`QX`	Modifier attesting to certified assistant (when applicable)	Rare for infusions but used if billing rules require attestation.
`JW`	Discarded drug amount (repeated for emphasis on wastage reporting)	See `JW` above.

Taxonomy Code	Specialty	Notes
`163W00000X`	Allergy & Immunology	Specialists who diagnose and manage primary immunodeficiency and prescribe IVIG.
`207R00000X`	Internal Medicine	Hospitalists and internists who coordinate chronic IVIG therapy in outpatient settings.
`251B00000X`	Registered Nurse	Nurses who perform IV access, infusion administration, and monitoring.
`363L00000X`	Pharmacy	Pharmacists who prepare and verify IVIG dosing and lot documentation.
`207P00000X`	Pediatric Medicine	Pediatricians who prescribe and oversee IG therapy for children with immunodeficiency.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D83.9`	Common variable immunodeficiency (CVID), unspecified	A primary immunodeficiency commonly treated with regular IVIG to reduce infection frequency.
`D80.9`	Immunodeficiency with predominantly antibody defect, unspecified	Indicates antibody production defects managed with immune globulin replacement.
`D72.8`	Other specified disorders of white blood cells	May reflect immune dysfunction where IVIG is indicated for immune modulation.
`M35.9`	Systemic involvement of connective tissue disorder, unspecified	Autoimmune/connective tissue diseases sometimes treated with IVIG for immunomodulatory effect.
`G61.0`	Guillain-Barré syndrome	An acute autoimmune neuropathy for which IVIG is a standard therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Performed prior to infusion for baseline labs, trough levels, or pre-infusion testing.
`36561`	Insertion of peripheral venous catheter, for infusion	Report when IV access is placed specifically for infusion administration.
`96365`	Intravenous infusion, initial, up to 1 hour	Used for reporting the infusion administration of therapeutic IV drugs when applicable and when payers require infusion time reporting in addition to J-code.
`96366`	Intravenous infusion, each additional hour	Used for prolonged infusions beyond the initial hour for rate-limited IVIG administration.
`99070`	Supplies and materials provided by the physician over and above those usually included with the service	Used for non-billable supplies associated with infusion when payer rules allow.

Related Codes

HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS J0120: Injection, Tetracycline, Up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS J0122: Injection, Eravacycline, 1 mg

HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

HCPCS J0129: Abatacept Injection, 10 mg

HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

HCPCS Level II J0130: Injection abciximab, 10 mg

HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

HCPCS J0131: Injection Acetaminophen, 10 mg

HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

HCPCS J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS J0133: Injection, Acyclovir 5 mg

HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

HCPCS J0134: Injection, Acetaminophen (Fresenius Kabi), 10 mg

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Used when no special reporting modifier applies to the service.
`11`	Professional component	Applied when reporting the professional component if applicable to associated services (rare for drug J-codes).
`22`	Increased procedural services	When work or resource use is substantially greater than typical for associated services (e.g., prolonged monitoring for severe reaction).
`52`	Reduced services	When the service provided is partially reduced or eliminated at physician/provider discretion.
`53`	Discontinued procedure	When infusion is started but discontinued due to patient reaction or other contraindication.
`62`	Two surgeons	If two qualified professionals share responsibility for unrelated aspects of the encounter (uncommon for drug administration).
`78`	Unplanned return to OR by same physician following initial procedure	Rarely applicable; included when an infusion-related complication requires immediate return to operative care.
`80`	Assistant surgeon	When an assistant surgeon is involved in a related procedural service (not typical for medication infusion).
`JW`	Drug discarded/expired	When a portion of a single-use vial is discarded and must be reported for wastage not billed to the patient.
`JZ`	No drug wastage	When no part of the drug vial is discarded.
`KX`	Requirements specified in the medical policy are met	When treatment meets payer-specific medical necessity documentation rules.
`QK`	Monoclonal antibody administration — single infusion/initial administration (not specific to IG but used in some payer rules)	If a payer requires this modifier for initial or single-dose administrative reporting.
`QX`	Modifier attesting to certified assistant (when applicable)	Rare for infusions but used if billing rules require attestation.
`JW`	Discarded drug amount (repeated for emphasis on wastage reporting)	See `JW` above.

Taxonomy Code	Specialty	Notes
`163W00000X`	Allergy & Immunology	Specialists who diagnose and manage primary immunodeficiency and prescribe IVIG.
`207R00000X`	Internal Medicine	Hospitalists and internists who coordinate chronic IVIG therapy in outpatient settings.
`251B00000X`	Registered Nurse	Nurses who perform IV access, infusion administration, and monitoring.
`363L00000X`	Pharmacy	Pharmacists who prepare and verify IVIG dosing and lot documentation.
`207P00000X`	Pediatric Medicine	Pediatricians who prescribe and oversee IG therapy for children with immunodeficiency.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D83.9`	Common variable immunodeficiency (CVID), unspecified	A primary immunodeficiency commonly treated with regular IVIG to reduce infection frequency.
`D80.9`	Immunodeficiency with predominantly antibody defect, unspecified	Indicates antibody production defects managed with immune globulin replacement.
`D72.8`	Other specified disorders of white blood cells	May reflect immune dysfunction where IVIG is indicated for immune modulation.
`M35.9`	Systemic involvement of connective tissue disorder, unspecified	Autoimmune/connective tissue diseases sometimes treated with IVIG for immunomodulatory effect.
`G61.0`	Guillain-Barré syndrome	An acute autoimmune neuropathy for which IVIG is a standard therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Performed prior to infusion for baseline labs, trough levels, or pre-infusion testing.
`36561`	Insertion of peripheral venous catheter, for infusion	Report when IV access is placed specifically for infusion administration.
`96365`	Intravenous infusion, initial, up to 1 hour	Used for reporting the infusion administration of therapeutic IV drugs when applicable and when payers require infusion time reporting in addition to J-code.
`96366`	Intravenous infusion, each additional hour	Used for prolonged infusions beyond the initial hour for rate-limited IVIG administration.
`99070`	Supplies and materials provided by the physician over and above those usually included with the service	Used for non-billable supplies associated with infusion when payer rules allow.

Related Codes

HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS J0120: Injection, Tetracycline, Up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS J0122: Injection, Eravacycline, 1 mg

HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

HCPCS J0129: Abatacept Injection, 10 mg

HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

HCPCS Level II J0130: Injection abciximab, 10 mg

HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

HCPCS J0131: Injection Acetaminophen, 10 mg

HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

HCPCS J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS J0133: Injection, Acyclovir 5 mg

HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

HCPCS J0134: Injection, Acetaminophen (Fresenius Kabi), 10 mg

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

HCPCS J1556: Injection, Immune Globulin (BIVIGAM), 500 mg

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Billing Code Overview

HCPCS J1556: Injection, Immune Globulin (BIVIGAM), 500 mg

Sign up for hcpcs J1556 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code J1556 represent?

How is J1556 billed during an infusion encounter?

Which modifiers are commonly used with J1556 and when are they applied?

What other CPT codes or services commonly appear with J1556 on the claim?

Which diagnoses are commonly linked to claims using J1556?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code J1556 represent?

How is J1556 billed during an infusion encounter?

Which modifiers are commonly used with J1556 and when are they applied?

What other CPT codes or services commonly appear with J1556 on the claim?

Which diagnoses are commonly linked to claims using J1556?

References