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The guide explains that treating physicians are responsible for diagnosis code determination based on the medical record, and that listed CPT, HCPCS, and ICD-10-CM codes follow AMA or CMS guidance. It details eligible Medicare Part B maintenance coverage, notes Part D denial, provides relevant ICD-10-CM diagnosis code examples, and includes HCPCS and CPT administration code references plus NDC and prior authorization instructions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/hizentra-coding-information-diagnosis-and-icd-10-cm-billing-codes-for-20-scig-therapy/404752/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/hizentra-coding-information-diagnosis-and-icd-10-cm-billing-codes-for-20-scig-therapy/404752.png","ImageObject",300,407,{"name":92,"@type":93},"iuabcfuw","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-27",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Who is responsible for choosing the ICD-10-CM diagnosis codes for CIDP treatment?","Question",{"text":113,"@type":114},"The treating physician is solely responsible for diagnosis coding and for determining the appropriate ICD-10-CM codes supported by the medical record.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which Medicare coverage applies to maintenance treatment of CIDP with subcutaneous immunoglobulin?",{"text":118,"@type":114},"Maintenance treatment is only eligible for coverage under Medicare Part B, while claims for Part D coverage will be denied.",{"name":120,"@type":111,"acceptedAnswer":121},"What steps are required when a payer requires prior authorization for Hizentra billing?",{"text":122,"@type":114},"Request written approval and an authorization reference code, enter that code in Field 23 of CMS-1500 (or the equivalent electronic claim field with the specified qualifiers), and attach the approval letter to paper claims when required.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},404752,1790814314,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},3985747874027,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Coding Information for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)  \nDiagnosis and ICD-10-CM billing codes for  \n20% subcutaneous Ig (SCIg) therapy  \nPlease see full Important Safety Information on back and enclosed full prescribing information for Hizentra, including boxed warning.  \n2  \n\n| Hizentra Coding Information\u003Cbr>Diagnosis and billing codes for 20% SCIg therapy\u003Cbr>This resource provides information from a complex and evolving medical coding system. The treating physician is solely responsible for diagnosis coding and determination of the appropriate ICD-10-CM codes1 that describe the patient’s condition and are supported by the medical record. All codes listed in this guide are for informational purposes and are not an exhaustive list. The CPT®,2-4 HCPCS,5,6 and ICD-10-CM codes provided are based on AMA or CMS guidelines. The billing party is solely responsible for coding of services (eg, CPT coding) . Because government and other third-party payer coding requirements change periodically, please verify current coding requirements directly with the payer being billed. | Medicaid and most insurers cover Hizentra for the treatment of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) as maintenance therapy to prevent relapse of neuromuscular disability and impairment. Medicare Part B coverage falls within the External Infusion Pump Local Coverage Determination (LCD) administered by the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) . Medicaid coverage policy varies by state. Coverage by other payers varies by payer and provider contract. |\n| --- | --- |\n| ICD-10-CM Diagnosis Codes1\u003Cbr>The following ICD-10-CM codes1 may be used to identify patient medical conditions typically associated with Hizentra use.\u003Cbr>G61 Chronic inflammatory demyelinating polyneuritis\u003Cbr>G61 .81* Chronic inflammatory demyelinating polyneuritis\u003Cbr>Chronic inflammatory demyelinating polyneuropathy\u003Cbr>Chronic inflammatory demyelinating polyradiculoneuropathy\u003Cbr>Polyneuropathy (multiple nerve disorder)\u003Cbr>Polyneuropathy, chronic inflammatory demyelinating\u003Cbr>Polyradiculoneuropathy, chronic inflammatory demyelinating\u003Cbr>Polyradiculoneuropathy, inflammatory demyelinating\u003Cbr>ICD=International Classification of Diseases\u003Cbr>HCPCS=Healthcare Common Procedure Coding System\u003Cbr>CPT=Current Procedural Terminology\u003Cbr>Coverage for maintenance treatment of CIDP with subcutaneous immunoglobulin is only eligible for coverage under Medicare Part B.\u003Cbr>Claims for Part D coverage will be denied.\u003Cbr>*Medicare Part B–approved diagnosis codes for treatment with Hizentra in the home . All other diagnoses may qualify for coverage under Medicare Part D plans.\u003Cbr>\u003Cbr>Call us now for reimbursement support\u003Cbr>\u003Cbr>For assistance with Prior Authorization (PA), request a PA checklist or connect with a CSL Field Reimbursement Manager from Hizentra Connect.\u003Cbr>1-877-355-4447\u003Cbr>Monday–Friday, 8 AM to 8 PM ET | \u003Cbr>Prior Authorization\u003Cbr>When a payer requires prior authorization:\u003Cbr> Request the approval and authorization reference code in writing\u003Cbr> Insert the authorization reference code into Field 23 of the CMS-1500 claim form when billing for services. Enter the authorization reference code in the equivalent field on the electronic claim form (ASC 837P, Loop 2300, Segment REF02, with the Qualifier G1 entered to Segment REF01), unless otherwise directed by the payer\u003Cbr> If required by the payer, attach a copy of the authorization approval letter to the paper claim\u003Cbr>form; use the payer’s designated procedure\u003Cbr>for submitting documentation with electronic claim forms\u003Cbr>Please see full Important Safety Information on back and enclosed full prescribing information for Hizentra, including boxed warning.\u003Cbr>|\n\n3  \n\n| Billing Codes\u003Cbr>The following HCPCS codes describe supplies (including drugs) rendered by the billing provider. CMS publishes and maintains the HCPCS code set. These codes are entered to paper claim form CMS-150","cbCailJ2cSHs73M9","https://ap.wps.com/l/cbCailJ2cSHs73M9","pdf",2548805,18,"English","# ICD-10-CM Diagnosis Codes\n## Prior Authorization (PA)","[{\"question\":\"Who is responsible for choosing the ICD-10-CM diagnosis codes for CIDP treatment?\",\"answer\":\"The treating physician is solely responsible for diagnosis coding and for determining the appropriate ICD-10-CM codes supported by the medical record.\"},{\"question\":\"Which Medicare coverage applies to maintenance treatment of CIDP with subcutaneous immunoglobulin?\",\"answer\":\"Maintenance treatment is only eligible for coverage under Medicare Part B, while claims for Part D coverage will be denied.\"},{\"question\":\"What steps are required when a payer requires prior authorization for Hizentra billing?\",\"answer\":\"Request written approval and an authorization reference code, enter that code in Field 23 of CMS-1500 (or the equivalent electronic claim field with the specified qualifiers), and attach the approval letter to paper claims when required.\"}]","Hizentra Coding Information - Diagnosis and ICD-10-CM billing codes for 20% SCIg therapy | PDF",1790550443,45]