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HCPCS J1572: Intravenous Immune Globulin (Flebogamma) 500 mg

HCPCS Level II code J1572 represents a 500 mg vial of intravenous immune globulin (flebogamma/flebogamma dif), packaged as a non-lyophilized (liquid) formulation. Nationally, immune globulin therapies are clinically important for treating immune deficiencies, autoimmune and inflammatory disorders, and certain acute conditions; accurate coding for product, dosing, and site of service drives billing, inventory tracking, and clinical documentation.

This publication analyzes coverage and billing considerations for major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, common service settings, and benchmark metrics where available. The report summarizes clinical context for intravenous immune globulin use, highlights typical sites of administration (hospital outpatient and ambulatory infusion centers), and outlines where data was not available in the input.

The piece is designed to help revenue integrity, clinical billing teams, and policy analysts understand how HCPCS Level II code J1572 is used in practice, what payers commonly cover, and what types of operational and documentation elements are most relevant. Data not available in the input is noted when applicable; the main focus remains on the clinical description, service type, and national payer coverage landscape.

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Billing Code Overview

HCPCS Level II code J1572 describes an intravenous injection of immune globulin (flebogamma/flebogamma dif), non-lyophilized (liquid), 500 mg. This code represents the drug product and dosage unit used when administering immune globulin intravenously.

Service Type: Intravenous immune globulin infusion (medication administration)

Typical Site of Service: Hospital outpatient infusion center, ambulatory infusion center, or clinic setting

Data not available in the input.

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HCPCS J1572: Intravenous Immune Globulin (Flebogamma) 500 mg

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Get alerted when payer policies referencing J1572 are released or updated.

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Billing Code Overview

Service Type: Intravenous immune globulin infusion (medication administration)

Typical Site of Service: Hospital outpatient infusion center, ambulatory infusion center, or clinic setting

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with primary immunodeficiency presents to an outpatient infusion center for scheduled intravenous immune globulin replacement therapy. The patient has a prescription for intravenous immune globulin, supplied as a liquid formulation (e.g., Flebogamma DIF), dosed to deliver multiple grams per infusion; billing is per 500 mg unit using J1572. The clinical workflow begins with nursing triage and vital signs, verification of the medication order and dose by the infusion pharmacist, venous access placement or use of existing port, pre-medication assessment (antipyretic or antihistamine as indicated), and administration of the infusion under nursing supervision with rate escalation per protocol. Monitoring includes vital signs at baseline and periodically during the infusion, documentation of any infusion-related reactions, and post-infusion observation for delayed adverse events. The encounter may occur in an outpatient hospital infusion suite, freestanding infusion center, or physician office with appropriate emergency support available. Documentation includes the signed medication administration record, lot number and vial count, indication tied to an ICD-10 diagnosis, and any applicable modifier usage for billing nuances (e.g., JG for multiple payer reporting, QX for rendering clinician eligibility when applicable).

Coding Specifications

Modifier	Description	When to Use
`11`	Primary procedure	When this infusion encounter is the main service provided during the visit
`22`	Increased procedural service	For unusually complex preparation or administration requiring substantially greater resources
`23`	Unusual anesthesia	If significant anesthesia is required for venous access (rare)
`52`	Reduced services	When the infusion is partially provided or stopped prior to full planned dose
`53`	Discontinued procedure	If the infusion is terminated due to acute adverse reaction before therapeutic dose administered
`54`	Surgical care only	Not typically used but available if only surgical component is billed separately
`55`	Postoperative management only	Not typically applicable to infusion services
`56`	Preoperative management only	Rarely used; not typical for routine IVIG infusions
`62`	Two surgeons	Not applicable to infusion care; included only when multiple physicians share responsibility for a procedure
`78`	Return to operating room	Not applicable to infusion procedures
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Rarely relevant to infusion-alone visits
`CQ`	Service furnished by a CRNA when a physician is not present	Applicable if anesthesia services are provided by CRNA during venous access or complex infusion
`JG`	Service rendered under TRICARE/CHAMPVA? (multiple payer reporting)	Use when payer-specific reporting requires this modifier for professional services associated with the infusion
`JZ`	Drug administered to self or patient-administered; no third-party to administer	Use when the patient self-administers a biologic under supervision and billing rules permit

Taxonomy Code	Specialty	Notes
`163W00000X`	Allergy & Immunology	Specialists prescribing and overseeing immune globulin replacement therapy
`207L00000X`	Hematology	Hematologists manage immune-mediated cytopenias or related disorders requiring IVIG
`208000000X`	Internal Medicine	Hospitalists and internists frequently coordinate chronic IVIG infusions
`163S00000X`	Clinical Immunology	Providers focused on primary immunodeficiency care and IG replacement
`368N00000X`	Nursing	Infusion nurses performing administration and monitoring

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D83.9`	Common variable immunodeficiency, unspecified	Primary indication for regular IVIG replacement to reduce infections
`D80.9`	Immunodeficiency, unspecified	General immunodeficiency diagnoses requiring immune globulin therapy
`D84.9`	Complement deficiency, unspecified	Complement disorders managed in some cases with immunoglobulin support
`G61.0`	Guillain-Barré syndrome	IVIG is a standard acute therapy for immune-mediated neuropathies
`M35.3`	Antisynthetase syndrome/dermatomyositis/polymyositis group (include immune-mediated myopathies)	Autoimmune neuromuscular or connective tissue conditions where IVIG is used as immunomodulatory therapy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, IV infusion technique; up to 1 hour, single or initial substance/drug	Used for reporting infusion time and administration for high-acuity IV infusions when payer allows for non-chemotherapy biologic infusion time reporting
`96415`	Each additional hour, infusion therapy (List separately in addition to code for primary infusion)	Applied when IVIG infusion extends beyond the initial infusion hour and time-based infusion reporting is appropriate
`36415`	Collection of venous blood by venipuncture	Performed for baseline labs and monitoring (e.g., CBC, CMP, immunoglobulin levels) related to IVIG therapy
`96365`	Intravenous infusion, therapeutic, prophylactic, or diagnostic; initial, up to 1 hour	Alternative coding for non-chemotherapy therapeutic IV infusions in some outpatient settings
`99070`	Supplies and materials provided by physician over and above those usually included with the office visit	Used to bill for special infusion supplies when payer policy permits

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

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
`11`	Primary procedure	When this infusion encounter is the main service provided during the visit
`22`	Increased procedural service	For unusually complex preparation or administration requiring substantially greater resources
`23`	Unusual anesthesia	If significant anesthesia is required for venous access (rare)
`52`	Reduced services	When the infusion is partially provided or stopped prior to full planned dose
`53`	Discontinued procedure	If the infusion is terminated due to acute adverse reaction before therapeutic dose administered
`54`	Surgical care only	Not typically used but available if only surgical component is billed separately
`55`	Postoperative management only	Not typically applicable to infusion services
`56`	Preoperative management only	Rarely used; not typical for routine IVIG infusions
`62`	Two surgeons	Not applicable to infusion care; included only when multiple physicians share responsibility for a procedure
`78`	Return to operating room	Not applicable to infusion procedures
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Rarely relevant to infusion-alone visits
`CQ`	Service furnished by a CRNA when a physician is not present	Applicable if anesthesia services are provided by CRNA during venous access or complex infusion
`JG`	Service rendered under TRICARE/CHAMPVA? (multiple payer reporting)	Use when payer-specific reporting requires this modifier for professional services associated with the infusion
`JZ`	Drug administered to self or patient-administered; no third-party to administer	Use when the patient self-administers a biologic under supervision and billing rules permit

Taxonomy Code	Specialty	Notes
`163W00000X`	Allergy & Immunology	Specialists prescribing and overseeing immune globulin replacement therapy
`207L00000X`	Hematology	Hematologists manage immune-mediated cytopenias or related disorders requiring IVIG
`208000000X`	Internal Medicine	Hospitalists and internists frequently coordinate chronic IVIG infusions
`163S00000X`	Clinical Immunology	Providers focused on primary immunodeficiency care and IG replacement
`368N00000X`	Nursing	Infusion nurses performing administration and monitoring

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D83.9`	Common variable immunodeficiency, unspecified	Primary indication for regular IVIG replacement to reduce infections
`D80.9`	Immunodeficiency, unspecified	General immunodeficiency diagnoses requiring immune globulin therapy
`D84.9`	Complement deficiency, unspecified	Complement disorders managed in some cases with immunoglobulin support
`G61.0`	Guillain-Barré syndrome	IVIG is a standard acute therapy for immune-mediated neuropathies
`M35.3`	Antisynthetase syndrome/dermatomyositis/polymyositis group (include immune-mediated myopathies)	Autoimmune neuromuscular or connective tissue conditions where IVIG is used as immunomodulatory therapy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, IV infusion technique; up to 1 hour, single or initial substance/drug	Used for reporting infusion time and administration for high-acuity IV infusions when payer allows for non-chemotherapy biologic infusion time reporting
`96415`	Each additional hour, infusion therapy (List separately in addition to code for primary infusion)	Applied when IVIG infusion extends beyond the initial infusion hour and time-based infusion reporting is appropriate
`36415`	Collection of venous blood by venipuncture	Performed for baseline labs and monitoring (e.g., CBC, CMP, immunoglobulin levels) related to IVIG therapy
`96365`	Intravenous infusion, therapeutic, prophylactic, or diagnostic; initial, up to 1 hour	Alternative coding for non-chemotherapy therapeutic IV infusions in some outpatient settings
`99070`	Supplies and materials provided by physician over and above those usually included with the office visit	Used to bill for special infusion supplies when payer policy permits

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

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.