Get United Healthcare Ivig Prior Authorization Form

For patients who respond to initial therapy, IVIG may be repeated every 4 to 12 weeks for symptom recurrence (Ref). Multifocal motor neuropathy: Initial: IV: 2 g/kg administered in divided doses over 2 to 5 consecutive days (eg, 400 mg/kg once daily for 5 days) (maximum total daily dose: 1 g/kg) (Ref).

• IVIg should be infused at: - An initial rate (test dose) of 0.3ml/kg/hour for 30 minutes. - If well tolerated, the rate of administration may be increased to. 0.6ml/kg/hour for a further 30 minutes. - Subsequent increases could be to 1.2ml/kg/hour and so on, up to. the maximum approved rate.

Q: Does treatment with IVIG require any pretesting and/or premedication? A: Yes, before treatment with IVIG, IgA level is checked to ensure patient is not IgA deficient. Prior to treatment, patients are usually pre-medicated with acetaminophen 650 to 1000 mg, diphenhydramine 50 mg.

The specialty pharmacy will bill Medicare for your IVIG drugs and will bill Medicare for the per-visit payment for nursing and supplies needed to administer the IVIG. You will be responsible for paying any applicable Medicare Part B deductible or coinsurance.

Article - Billing and Coding: Intravenous Immune Globulin (IVIG) (A52446)

The initial dose for substitution therapy is 0.2 g/kg body weight repeated monthly. If necessary, the dose may be increased to 0.3 g/kg and the frequency to every 2-3 weeks. The approved dosage for ITP is 0.4 g/kg daily for 2 to 5 consecutive days. Repeat doses of 0.4 g/kg have been used as maintenance therapy.