Immune Globulin Intravenous (IVIg) (L34314) - R13 - Effective February 1, 2020

Date Posted: January 29, 2026

This Local Coverage Determination (LCD) has been revised under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

Effective Date: February 1, 2020

Summary of Changes:

Policy was updated to correct typographical errors. Under Coverage Indications, Limitations and/or Medical Necessity, corrected 'nonresponsiveness' to 'non-responsiveness.' Under Associated Information, corrected 'and An' to 'and an.'

Visit the Noridian Active LCDs webpage to view the Active LCD or access it via the CMS MCD.

Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )