Coding Corner Question

A 65-year-old male diagnosed with chronic inflammatory demyelinating polyneuropathy is scheduled for a follow-up visit for an intravenous immune globulin (IVIg) infusion.

The patient advises the physician that he is also having minor joint pain in his left knee. The physician performs a detailed history and an expanded, problem-focused examination. The physician’s notes support medical decision-making of moderate complexity.

The IVIg infusion duration is three hours and 38 minutes. The patient is infused with 25 grams of Octagam, and one 250-cc bag of normal saline is used to establish venous access. How should this office visit be coded?

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Although initially given as replacement therapy for patients with primary and secondary immunodeficiency states, intravenous immunoglobulin (IVIg) has proven to be effective in the treatment of various autoimmune and inflammatory disorders. This success has led to a dramatic increase in the use of IVIg, with its use as an antiinflammatory agent now vastly surpassing its use in the treatment of immunodeficiencies. Even so, the basis for the antiinflammatory activity of IVIg remains unclear.

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