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Independence Blue CrossCommercial · Coverage · Medical Policy · Allergy & Immunology, Hematology, Infectious Disease +4 moreMedium impact

08.00.13al, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)

Act
by Oct 1, 2025
Effective date
Oct 1, 2025
Identified
Jun 19, 2026

Summary

Independence Blue Cross updated policy 08.00.13al to version 08.00.13ao, removing coverage for Functional disorders of polymorphonuclear neutrophils (D71) and broad Multiple sclerosis (G35), while adding coverage for the more specific diagnosis code Relapsing-remitting multiple sclerosis (G35.A). Billing teams must update diagnosis code logic to reflect these ICD-10 changes effective October 1, 2025.

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What to do

by Oct 1, 2025 · 3 steps
01Billing team must update billing system edits and claim validation rules to deny claims for IVIG/SCIG (HCPCS J1555, J1558, J1559, J1561, J1569, J1575) when submitted with diagnosis code D71 (Functional disorders of polymorphonuclear neutrophils) or the broad G35 (Multiple sclerosis).
02Update system to accept claims with diagnosis code G35.A (Relapsing-remitting multiple sclerosis) instead.
03Modify intake forms and provider education materials to clarify that only G35.A—not general G35 codes—are covered for MS. Claims submitted with removed diagnosis codes will be denied and require resubmission.

Codes mentioned

J1555J1558J1559J1561J1569J1575D71G35G35.A

Original notice

08.00.13al, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

See all Independence Blue Cross changes →
MA08.009z, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)LowEffective Jul 1, 2026 · Medical Policy08.00.13ao, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)LowEffective Jul 1, 2026 · Medical PolicyMA08.009w, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)MediumEffective Jan 1, 2025 · Medical PolicyMA08.009y, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)MediumEffective Apr 1, 2026 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesAllergy & ImmunologyHematologyInfectious DiseaseNeurologyDermatologyPediatricsOncologyCode J1555Code J1558Code J1559Code J1561Code J1569Code J1575Code D71Code G35Code G35.A

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