All PlansPrior AuthHigh impact
Intravenous Immune Globulin (IVIG) - Alyglo™ (Immune Globulin Intravenous (Human)-stwk) Asceniv™ (Immune Globulin Intravenous (Human) - slra); Bivigam®; Flebogamma® DIF; Gammagard® Liquid; Gammagard® Liquid ERC; Gammagard® S/D; Gammaked™; Gammaplex®; Gamunex®-C; Octagam®; Panzyga ® (Immune Globulin Intravenous (Human) - ifas); Privigen®; Qivigy® (Immune Globulin Intravenous (Human) - kthm); Yimmugo® (Immune Globulin Intravenous (Human) - dira)
BCBS Tennessee·Immunology, Hematology, Oncology +4 more·Medical Policy
Effective date
Jun 30, 2026
We identified it
Jun 17, 2026
Summary
New comprehensive policy for Intravenous Immune Globulin (IVIG) therapy covering 14 different IVIG products with detailed prior authorization requirements for both FDA-approved and compendial uses. The policy establishes specific coverage criteria and documentation requirements for various conditions including primary immunodeficiency, ITP, CIDP, and multiple other indications.
Action Required
Before June 30, 2026: Billing team must implement prior authorization processes for all IVIG therapies. Update billing system to flag IVIG claims requiring prior auth documentation including diagnostic test results, laboratory reports with immunoglobulin levels, and condition-specific clinical records. Train staff on the extensive documentation requirements for each covered indication. Failure to obtain prior authorization and proper documentation will result in claim denials.