Local Coverage Determination · DME MAC
L33610
Intravenous Immune Globulin
Version 70. CMS effective date 07/01/2026. CMS updated 06/19/2026. Read from the CMS Coverage API on 2026-10-13. Contractors on the report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
CMS coverage policy citation. None
Coverage indication
In addition to the “reasonable and necessary” criteria contained in this LCD there are other payment rules, which are discussed in the following documents, that must also be met prior to Medicare reimbursement: The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section. The LCD-related Policy Article, located at the bottom of this policy under the Related Local Coverage Documents section. Refer to the Supplier Manual for additional information on documentation requirements. Refer to the DME MAC web sites for additional bulletin articles and other publications related to this LCD. The statutory coverage criteria for intravenous immune globulin (IVIG) addressed in this policy are specified in the related Policy Article. For the items addressed in this LCD, the “reasonable and necessary” criteria, based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity. Drugs may be covered only if dispensed and billed to Medicare by the entity that actually dispenses the drug to the Medicare beneficiary, and that entity must be permitted under all applicable federal, state, and local laws and regulations to dispense drugs. Only entities licensed in the state where they are physically located may bill for IVIG. Claims submitted by entities not licensed to dispense drugs will be denied for as not reasonable and necessary.
Excerpt from the LCD indication. Full text on CMS.
Documentation requirements
Items covered in this LCD have additional policy-specific requirements that must be met prior to Medicare reimbursement. Refer to the LCD-related Policy article, located at the bottom of this policy under the Related Local Coverage Documents section for additional information.
Related articles
- A55426 · Standard Documentation Requirements for All Claims Submitted to DME MACs
- A52509 · Intravenous Immune Globulin - Policy Article
HCPCS codes on this LCD
17 other Level II codes are on the LCD and are not given a page in this set: J1459, J1552, J1553, J1554, J1556, J1557, J1561, J1566, J1568, J1569, J1572, J1573, J1576, J1577, J1599, J2791, Q2052.
Questions
What does LCD L33610 cover?
L33610 is Intravenous Immune Globulin. It is a current final DME MAC local coverage determination, version 70.
Where is the CMS source for L33610?
The Medicare Coverage Database page for LCD L33610 version 70.
Get the signed answer via API
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=A4223&as_of=2024-01-15&npi=1234567890&state=UT"