Cigna IVIG/SCIG Coverage Update

Coverage Criteria for Immune Globulin (IVIG/SCIG)

inv-01: General medical necessity — Immune globulin products are medically necessary when BOTH of the following are met

Immune globulin products are considered medically necessary when BOTH of the following are met:

General: 1) Individual meets the Specific Medical Necessity Criteria by Condition (see condition-specific sections I–VIII). 2) Non-Covered Product Criteria is met (refer to Non-Covered Product Table).

See condition-specific sections for details.

inv-02: I. Primary Immunodeficiency Disorder (PID) — Covered when ALL of the following are met

Covered when ALL of the following are met:

PID - Hypogammaglobulinemia/CVID: Immunologic evaluation including documented serum IgG below the laboratory's lower limit of normal on at least two occasions; impaired antibody response demonstrated by EITHER lack of protective titers to protein antigens (tetanus and diphtheria or HiB) measured 3–4 weeks after immunization OR inadequate responsiveness to pneumococcal polysaccharide vaccine (Pneumovax 23) 4–8 weeks after vaccination (age <6 years: <50% serotypes protective; age ≥6 years: <70% serotypes protective); AND history of recurrent bacterial sinopulmonary infections requiring multiple courses or prolonged antibiotics with management of predisposing conditions and supporting imaging/labs.IgG below lab lower limit on 2 occasions; pneumococcal response thresholds per age

Selected specific PIDs: One of: agammaglobulinemia (serum IgG <200 mg/dL); extremely low (<2%) or absent B cells (CD19+); documentation of a recognized genetic defect supporting diagnosis; OR transient hypogammaglobulinemia of infancy with age‑specific low immunoglobulins plus BOTH recurrent bacterial sinopulmonary infections and inadequate pneumococcal response (IVIG limited to up to 6 months before re-evaluation).IgG <200 mg/dL for agammaglobulinemia

Transient infant therapy limited to up to 6 months before reevaluation.

inv-03: II. Secondary Immunodeficiency — Covered when condition-specific criteria are met

Covered when condition-specific criteria are met.

Acquired immunosuppression: Presence of hypogammaglobulinemia with serum IgG <400 mg/dL; immunosuppression attributed to an identified cause (examples: major surgery such as cardiac transplant, hematologic malignancy, extensive burns, collagen‑vascular disease); AND recurrent sinopulmonary infections or history of serious bacterial infections.IgG <400 mg/dL

CLL: Serum IgG <500 mg/dL AND recurrent sinopulmonary infection or history of serious bacterial infection(s).IgG <500 mg/dL

Multiple myeloma: A. Initial therapy: Approve for 6 months when patient either has or is at risk for severe/recurrent infections OR is starting/receiving CAR‑T or bispecific antibody therapy, and medication is prescribed by or in consultation with a hematologist/oncologist/infectious disease specialist. B. If currently receiving immune globulin, approve for 1 year.

inv-04: III. Infectious Disease — Covered for specified post-exposure prophylaxis or acute treatment when criteria met

Covered for specified post-exposure prophylaxis or acute treatment when criteria met.

Measles post-exposure prophylaxis: Prophylaxis when ANY of the following are met: pregnant women without evidence of measles immunity; severe primary immunodeficiency; bone marrow transplant recipients until ≥12 months after completing immunosuppression (longer if GVHD); individuals on/within 6 months of ALL chemotherapy; persons with AIDS or severe immunosuppression (CD4% <15% or CD4 <200) who have not received MMR since effective ART.

Toxic shock syndrome: Acute treatment for staphylococcal or streptococcal toxic shock syndrome when any of: infection refractory to aggressive treatment; presence of an undrainable focus; or persistent oliguria with pulmonary edema.

Tetanus/Varicella post-exposure: Tetanus PEP or treatment when tetanus immune globulin is unavailable; varicella post-exposure prophylaxis when Varicella Immune Globulin is unavailable (VariZIG preferred for high‑risk individuals).

When specific products unavailable, IVIG may be used per CDC guidance (see dosing sections).

inv-05: IV. Transplantation — Covered for prevention or treatment in transplant settings when specific criteria are met

Covered for prevention or treatment in transplant settings when specific criteria are met.

HCT recipients: Prevention of infection in HCT recipients with hypogammaglobulinemia (serum IgG <400 mg/dL) AND either within the first 100 days after transplant OR after 100 days with recurrent infections or evidence of graft‑versus‑host disease.IgG <400 mg/dL; within 100 days or after with infections/GVHD

Solid organ transplant - desensitization: Desensitization therapy prior to or immediately after transplantation: authorization for a maximum dose of 2 g/kg monthly for 4 consecutive months; additional infusions at 12 and 24 months may be authorized if transplant not yet undergone.2 g/kg monthly x4

Solid organ transplant - AMR: Antibody‑mediated rejection: initial authorization up to 2 g/kg monthly for 3 months; reauthorization up to 3 months dependent on documented beneficial clinical response.

inv-06: V. Hematology — Covered for multiple hematologic conditions with indication-specific criteria

Covered for multiple hematologic conditions with indication-specific criteria.

Chronic parvovirus B19 anemia: Treatment for severe, refractory anemia with evidence of parvovirus B19 viremia.

Evan's syndrome: Treatment when there is failure, contraindication, or intolerance to alternative therapies (azathioprine, cyclophosphamide, cyclosporine, prednisone).

Fetal alloimmune thrombocytopenia (FAIT): Documentation of maternal antibodies to a paternal platelet antigen AND either a previous pregnancy complicated by FAIT OR fetal blood sampling documenting thrombocytopenia.

Immune thrombocytopenia (ITP) - Adult: Platelet count <30,000/mm3 AND one of: clinical need to rapidly increase platelets (e.g., active bleeding, preoperative), OR not a candidate/relapsed post‑splenectomy AND failure/contraindication/intolerance to corticosteroids or thrombopoietin receptor agonists.

inv-07: VI. Neurology — Covered when specified diagnostic and testing criteria for demyelinating neuropathies are satisfied

Covered when specified diagnostic and testing criteria for demyelinating neuropathies are satisfied.

CIDP initial authorization: Progressive or relapsing motor and/or sensory symptoms in more than one limb AND hyporeflexia or areflexia present for at least 2 months (documented by objective measurement); electrophysiologic findings indicating demyelinating neuropathy meeting at least 3 of 4 AAN criteria (partial conduction block of ≥1 motor nerve; reduced conduction velocity of ≥2 motor nerves; prolonged distal latency of ≥2 motor nerves; prolonged/absent F‑waves of ≥2 motor nerves); AND exclusion of other causes of demyelinating neuropathy per EFNS/PNS guidance.>= 2 months; 3 of 4 electrophysiologic criteria

Supportive CSF, MRI, or nerve biopsy results when available.

inv-08: CIDP (including MADSAM/Lewis-Sumner syndrome) — Initial authorization (3 months) — Approve when ALL criteria met

Approve for initial treatment (3 months per section) when ALL of the following are met:

CIDP initial criteria: Progressive or relapsing motor and/or sensory symptoms of more than one limb AND hyporeflexia or areflexia in affected limbs present for at least 2 months as documented by objective measurement.>= 2 months

Documented by objective measurement

Electrophysiologic criteria: Electrophysiologic findings indicate demyelinating neuropathy with at least 3 of the following 4 AAN criteria: partial conduction block of ≥1 motor nerve; reduced conduction velocity of ≥2 motor nerves; prolonged distal latency of ≥2 motor nerves; prolonged F‑wave latencies of ≥2 motor nerves or absence of F waves.3 of 4 criteria

AAN definitions apply

Exclusion of other causes:

inv-09: CIDP — Reauthorization / Long-term

For reauthorizations and long-term treatment

Objective improvement: Significant improvement in clinical condition documented by objective measurement (examples: INCAT sensory sum score, grip strength by hand‑held dynamometer, MRC scales) and, when applicable, reduction in sensory loss.

See Appendix for example measures

Dose management: For long‑term treatment, evidence that dose has been periodically reduced or treatment withdrawn with measurement of effects to establish ongoing need.

inv-10: Guillain-Barré Syndrome (GBS) — Acute treatment — Acute treatment when ALL criteria are met

Acute treatment when ALL of the following criteria are met:

Timing: Initial treatment within 4 weeks of the onset of symptoms.

No concomitant plasmapheresis: No concomitant use of plasmapheresis during the treatment course.

Repeat course: Treatment may be repeated once but should not extend beyond 8 weeks from onset of symptoms.

inv-11: Lambert-Eaton Myasthenic Syndrome (LEMS) — Treatment criteria

Treatment when:

LEMS indication: There is failure, contraindication, or intolerance to other symptomatic therapies (for example, acetylcholinesterase inhibitors such as pyridostigmine and immunosuppressants such as prednisone or azathioprine).

inv-12: Multifocal Motor Neuropathy (MMN) — Treatment when BOTH are present

Treatment when BOTH are present:

MMN criteria: Progressive symptoms present for at least 1 month AND diagnosis of definite or probable multifocal motor neuropathy per AANEM (definite: conduction block in ≥2 nerves outside entrapment sites with normal sensory studies; probable criteria as defined by AANEM appendices).

inv-13: Myasthenia Gravis (MG) — Treatment when ANY of the following is present (selected contexts included)

Treatment when ANY of the following is present (selected contexts included):

Peri-thymectomy: IVIG use before planned thymectomy or during the post‑operative period following thymectomy.

Acute crisis: During an acute myasthenic crisis (for example, significant dysphagia, respiratory failure, or inability to perform activities) — duration should not exceed 5 days.

Refractory MG initial treatment: Documented failure or inadequate response to pyridostigmine; failure/intolerance/not a candidate for corticosteroid maintenance; failure or inadequate response to at least one nonsteroidal immunosuppressive agent (e.g., azathioprine, cyclosporine, cyclophosphamide, mycophenolate, methotrexate, tacrolimus); AND failure or contraindication to thymectomy for AChR antibody‑positive individuals.

inv-14: Dermatomyositis / Polymyositis — Treatment when BOTH are present

Treatment when BOTH are present:

Myositis criteria: Documented dermatomyositis or polymyositis established by biopsy AND either failure of standard medical therapy (corticosteroids AND immunosuppressives) OR profound, rapidly progressive and/or potentially life‑threatening muscular weakness.

inv-15: Autoimmune mucocutaneous blistering diseases — Treatment when EITHER criterion is met

Treatment when EITHER criterion is met:

Blistering disease criteria: Failure, contraindication, or intolerance of conventional therapy (corticosteroids, azathioprine, cyclophosphamide, mycophenolate) OR rapidly progressive disease where conventional agents cannot act quickly enough; IVIG given along with conventional treatments only until they take effect.

inv-16: Other indicated and guideline-supported uses — overview; coverage depends on meeting specific criteria elsewhere

IVIG is covered for multiple FDA‑approved and guideline‑supported indications; examples and context follow:

FDA-approved indications: Includes primary humoral immunodeficiency replacement, CIDP, dermatomyositis (Octagam 10%), ITP (acute and chronic when rapid platelet rise required), Kawasaki disease (acute pediatric), multifocal motor neuropathy.

Transplant/ABMR and desensitization: Used for antibody‑mediated rejection and desensitization in transplantation along with plasmapheresis and other agents per guidelines.

HCT infection prevention: Used in HCT recipients with severe hypogammaglobulinemia (serum IgG <400 mg/dL) during the first 100 days and beyond when indicated; dosing individualized to maintain trough IgG >400–500 mg/dL.

NMOSD and other neurologic uses: IVIG recommended in children or when contraindications to long‑term agents for AQP4‑IgG positive NMOSD; IVIG recommended in GBS within 2–4 weeks per AAN/EAN guidance.

inv-17: IVIG to prevent infections in HCT recipients — Covered when ALL of the following are met

Covered when ALL of the following are met

HCT infection prevention criteria: 1) Recipient of hematopoietic cell transplantation (allogeneic or autologous). 2) Documented severe hypogammaglobulinemia (serum IgG <400 mg/dL) during the first 100 days after HCT for adults/adolescents (and in pediatric allogeneic HCT recipients). 3) Dosing plan aligned with guidelines (examples: adults/adolescents 0.5 g/kg per week during first 100 days; pediatric allogeneic 0.4 g/kg per month adjusted to keep IgG >400 mg/dL).IgG < 400 mg/dL

Dose individualized to maintain trough IgG >400–500 mg/dL; dosing >100 days post‑HCT 0.5 g/kg every 3–4 weeks.

inv-18: IVIG for secondary ITP (HIV or Hepatitis C) — Covered when ANY of the following per guideline context

Covered when ANY of the following per guideline context

Secondary ITP options: IVIG recommended as an initial treatment option for secondary ITP due to HIV; IVIG also recommended for secondary ITP associated with Hepatitis C. Document diagnosis of ITP secondary to HIV or Hepatitis C and clinical indication for IVIG.

ASH recommends corticosteroids, IVIG, or Rh0(D) immune globulin as initial therapy for HIV‑associated secondary ITP.

inv-19: Passive immunization — measles post-exposure prophylaxis — Covered when ALL of the following are met

Covered when ALL of the following are met

Measles PEP with IG: 1) Known significant exposure to measles. 2) Patient is nonimmune and in a high‑risk group (infant <12 months, pregnant woman without evidence of immunity, or severely immunocompromised person). 3) Immune globulin administered within 6 days of exposure; IVIG dose 400 mg/kg for pregnant or severely immunocompromised patients.within 6 days of exposure

Infants 6–11 months may receive MMR within 72 hours; intramuscular IG used for infants <12 months.

inv-20: Post-exposure prophylaxis for varicella and tetanus / treatment of parvovirus B19 — Covered when criterion-specific conditions apply

Covered when criterion-specific conditions apply

Varicella/tetanus/parvovirus uses: VariZIG indicated for high‑risk individuals after varicella exposure (single dose 400 mg/kg). If VariZIG unavailable, alternatives include oral antivirals or IVIG once within 10 days after exposure. If tetanus immune globulin is unavailable, immune globulin at 200–400 mg/kg may be used. IVIG is recommended for treatment of persistent parvovirus B19 infection in immunosuppressed patients lacking neutralizing antibodies (typical regimens 200–400 mg/kg/day for 5–10 days).timing and dose vary by exposure/indication

Document exposure timing, immunity status, and rationale for IVIG versus product‑specific alternatives (VariZIG/TIG).

inv-21: Neurologic and neuromuscular disorders (MOGAD, myasthenia gravis, Lambert-Eaton, immune-mediated necrotizing myopathy, GBS, etc.) — Covered when guideline-supported indications and dosing are met

Covered when guideline-supported indications and dosing are met

Neurologic IVIG coverage: IVIG is recommended by consensus/guideline bodies for conditions including MOGAD (typical IVIG loading 0.4 g/kg/day x5 with maintenance every 4 weeks at 0.4–2 g/kg), myasthenia gravis (crises, perioperative preparation, refractory disease; initial 2 g/kg over 2–5 days; maintenance 0.4–1 g/kg every 4 weeks), Lambert‑Eaton (when other therapies fail or are not tolerated), GBS (within 2–4 weeks per AAN/EAN), and immune‑mediated necrotizing myopathy where IVIG may be second‑line. Document diagnosis, severity, prior therapies, and prescribed IVIG dosing regimen.dosing per condition-specific guidance

Some recommendations specify IVIG after failure or intolerance of first‑line agents; document prior therapy when applicable.

inv-22: Hematologic and neonatal indications — Covered when guideline-specified conditions are met

Covered when guideline-specified conditions are met

Fetal/neonatal alloimmune thrombocytopenia and neonatal care: Antenatal IVIG administered to the mother is effective to increase fetal platelet counts in neonatal alloimmune thrombocytopenia; for affected newborns, first‑line therapy is antigen‑negative compatible platelets with IVIG as adjunctive therapy. Document maternal fetal diagnosis and treatment plan.

IVIG as adjunctive therapy for neonatal alloimmune thrombocytopenia.

inv-23: Covered Indications — Selected Genetic and Clinical PIDs described to support IVIG use

Selected primary immunodeficiency syndromes and related conditions are described to support IVIG use when clinically appropriate.

Selected PID diagnoses: Includes autosomal recessive agammaglobulinemia (ARA), autosomal recessive hyper‑IgM syndrome (HIM), combined immunodeficiency disorders (eg, A‑T, WAS, DGS, NBS, WHIM), congenital hypogammaglobulinemia (ICOS impaired), X‑linked agammaglobulinemia (BTK impaired), hyper‑IgE syndromes (STAT3 or DOCK8), hypogammaglobulinemia unspecified, ICF syndrome, Specific Antibody Deficiency (SAD), Selective IgG subclass deficiencies (IGGSD), SCID, and transient hypogammaglobulinemia of infancy.

Documented diagnosis and clinical features per listings support consideration for IVIG.

inv-24: Neuromuscular Indications and Diagnostic Criteria — Diagnostic and response assessment criteria to support IVIG use

Neuromuscular disorders: diagnostic and response assessment criteria to support IVIG use.

MMN definite criteria (AANEM): All of: weakness without objective sensory loss in distribution of ≥2 named nerves; definite conduction block present in ≥2 nerves outside entrapment sites; normal sensory nerve conduction velocity across same segments with demonstrated motor conduction block; normal sensory NCS on all tested nerves (≥3 nerves); absence of upper motor neuron signs.

Use AANEM consensus criteria as diagnostic basis for IVIG in MMN.

Probable MMN criteria: Presence of probable conduction block patterns per AANEM (eg, probable conduction block in ≥2 segments or combination of definite and probable blocks) with normal sensory studies and absence of UMN signs; probable MMN may support IVIG when documented.

Probable MMN may support IVIG when documented.

Certain immune globulin products are listed as non-covered for Employer Group and Individual and Family Plans unless specific step-therapy criteria are satisfied. For these products (examples include Alyglo, Asceniv, Gammagard S/D, Yimmugo), coverage requires either documentation that the member has trialed three specified alternative products or prescriber justification for a product-specific clinical need (for example, need for minimal XIa content, very low IgA, or elevated RSV antibody content). Providers should follow the plan-specific non-covered product criteria when requesting authorization.

The policy identifies specific conditions for which IVIG use is considered not medically necessary. Examples explicitly listed include: Hashimoto encephalopathy, inclusion body myositis (IBM), Lyme neuropathy, neonatal sepsis, PANS/PANDAS, primary progressive and secondary progressive multiple sclerosis (including acute MS exacerbations and clinically isolated syndrome), and recurrent pregnancy loss. This list is illustrative and not exhaustive; other uses not supported by the coverage criteria are similarly treated as not medically necessary.

The policy notes that Selective IgG subclass deficiencies (IGGSD) and Specific Antibody Deficiency (SAD) generally do not require routine IVIG replacement for control of recurrent bacterial infections. Only rare individuals with documented infection susceptibility despite normal vaccine responses may be considered for IVIG. For transient hypogammaglobulinemia of infancy, short-term IVIG replacement may be used for recurrent severe bacterial infections but is limited and subject to reevaluation.

Language in the Conditions Not Covered section was revised: indications previously described as 'experimental, investigational, or unproven' have been updated and are now stated as not medically necessary. This terminology change is reflected in the revision history and applies to exclusions unless specific medical necessity criteria indicate otherwise.

Claims or requests for IVIG/SCIG services that are submitted without a covered diagnosis or procedure code appropriate to this policy will be denied as not covered. Providers must bill using the most appropriate codes effective for the date of service and ensure the request meets the policy's medical necessity criteria.

Any use of immune globulin products that is not explicitly listed as covered or supported by the condition-specific medical necessity criteria is considered not medically necessary. The policy's 'Conditions Not Covered' list provides examples of such uses and is periodically updated as new evidence becomes available.

Routine IVIG replacement is generally not indicated for most patients with selective IgG subclass deficiencies or Specific Antibody Deficiency. The policy emphasizes that IVIG may be considered only for uncommon individuals who demonstrate clear clinical infection susceptibility despite otherwise adequate vaccine responses; routine replacement therapy for these diagnoses is excluded in most cases.

As noted in the revision summary, wording in exclusions has been standardized: references to indications described as 'experimental, investigational, or unproven' were replaced with the term not medically necessary to align policy language and denial rationale for uncovered indications.

Coding and Numeric Thresholds

Covered IVIG/SCIG Products (listed)mixedCovered

Product list

Alyglo; Asceniv; Bivigam; Cutaquig; Cuvitru; Flebogamma DIF; Gammagard Liquid; Gammagard S/D (<1 mcg/mL); Gammaked; Gammaplex; Gamunex-C; Hizentra; HyQvia; Octagam; Panzyga; Privigen; Xembify; Yimmugo; (and others listed)

Considered Medically Necessary when criteria met (examples)mixedCovered

90283	Immune globulin (IgIV), human, for intravenous use.
90284	Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
J1459	Injection, immune globulin (Privigen), intravenous, nonlyophilized (e.g., liquid), 500 mg.
J1551	Injection, immune globulin (Cutaquig), 100 mg.
J1552	Injection, immune globulin (Alyglo), 500 mg.
J1553	Injection, immune globulin (yimmugo), 100 mg (effective date 4/1/2026)

Considered Medically Necessary when criteria met (product-specific J-codes)HCPCSCovered

J1554	Injection, immune globulin (Asceniv), 500 mg.
J1555	Injection, immune globulin (Cuvitru), 100 mg.
J1556	Injection, immune globulin (Bivigam), 500 mg.
J1557	Injection, immune globulin (Gammaplex), intravenous, nonlyophilized (e.g., liquid), 500 mg.
J1558	Injection, immune globulin (Xembify), 100 mg.
J1559	Injection, immune globulin (Hizentra), 100 mg.
J1561	Injection, immune globulin (Gamunex/Gamunex-C/Gammaked), nonlyophilized (e.g., liquid), 500 mg.
J1566	Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg.
J1568	Injection, immune globulin (Octagam), intravenous, nonlyophilized (e.g., liquid), 500 mg.
J1569	Injection, immune globulin (Gammagard liquid), nonlyophilized (e.g., liquid), 500 mg.

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HCPCS coding updatesHCPCS

J1553	HCPCS code added (effective 4/1/2026)
J1552	HCPCS code added previously (effective 1/1/2024); effective date note later removed
J1599	HCPCS code removed
E0779	HCPCS code removed
E0781	HCPCS code removed

ICD-10-CM coding additionsICD-10

T45.AX5A	ICD-10-CM code added (effective 10/1/2024)
T45.AX5D	ICD-10-CM code added (effective 10/1/2024)
T45.AX5	ICD-10-CM code added (effective 10/1/2024)

Serum IgG thresholds — key policy values

PID - documented low IgGSerum IgG below the laboratory lower limit on at least two occasions (required for PID diagnosis)

Secondary immunodeficiency thresholdSerum IgG < 400 mg/dL for acquired immunosuppression or pediatric HIV prophylaxis

Agammaglobulinemia specific thresholdSerum IgG < 200 mg/dL cited for agammaglobulinemia in selected PID listings

Pneumococcal vaccine response thresholds

Age < 6 yearsProtective response defined as ≥1.3 mcg/mL per serotype; inadequate response = <50% of serotypes protective 4–8 weeks after Pneumovax 23

Provider Authorization, Documentation, and Billing Actions

Prior Authorization

Prior Authorization, Required Documentation, and Authorization Duration

Prior authorization is required for IVIG/SCIG requests and medical necessity is determined by condition-specific criteria. To support a prior authorization, submit documentation of the indication, a recent serum IgG level (when relevant), and a clear dosing plan (dose in g/kg, frequency, and route). Initial approvals are time-limited per Authorization Duration; ensure requests specify the intended duration.

Document indication, recent serum IgG, and dosing plan (dose g/kg, frequency, route).
Initial authorizations are time-limited (see Authorization Duration — typically up to 6 months; CIDP, PID, and refractory MG may allow up to 12 months).

Billing Rule

Updated HCPCS/Claims Coding Requirements and Denial Risk

Use current HCPCS coding on prior authorization requests and claims. The policy was updated to add HCPCS J1553 effective 4/1/2026 (and previously added J1552 1/1/2024); removed codes include J1599, E0779, and E0781. Failure to use the most accurate and up-to-date HCPCS/CPT/ICD-10 codes may lead to claim denials.

Background and Scope

Intravenous and subcutaneous immune globulin products are used for replacement therapy in primary and secondary immunodeficiencies and as immunomodulatory therapy across a range of clinical areas (infectious disease, transplantation, hematology, neurology, rheumatology, dermatology). The policy specifies condition‑ and test‑based thresholds (for example, documented low serum IgG measurements for PID and defined IgG thresholds for HCT recipients) and requires prior authorization with documentation of indication, relevant IgG levels, and a dosing plan consistent with guideline-recommended regimens.

Definitions and Diagnostic Thresholds

Partial conduction block — electrophysiologic definition

Partial conduction block definitionA drop of at least 20% in negative peak area or peak‑to‑peak amplitude with a change of <15% in duration between proximal and distal stimulation sites

Temporal dispersion distinctionPossible conduction block or temporal dispersion is a drop of ≥20% in area/amplitude with a change of ≥15% in duration

ApplicationDefinition used as one of the AAN electrophysiologic criteria for demyelination in CIDP

Reduced conduction velocity — electrophysiologic definition

Reduced conduction velocity thresholdConduction velocity <80% of the lower limit of normal if CMAP amplitude >80% of lower limit, or <70% if CMAP amplitude <80% of lower limit

Context

OpenPayer

Immune Globulin (IVIG/SCIG) Coverage

Coverage Criteria for Immune Globulin (IVIG/SCIG)

Coding and Numeric Thresholds

Provider Authorization, Documentation, and Billing Actions

Background and Scope

Definitions and Diagnostic Thresholds