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This chart highlights suggested coding for GAMMAGARD LIQUID and GAMMAGARD S/D. It is not a comprehensive listing of codes and physician and hospital staff may deem other codes more appropriate. It is the providers' responsibility to select the coding options that most accurately reflect the setting and services rendered. ICD-9 Codes for which GAMMAGARD LIQUID and GAMMAGARD S/D may be given.
204.10	B cell chronic lymphocytic leukemia (CLL)
279.00	Hypogammaglobulinemia, unspecified
279.03	Selective deficiency of IgG
279.04	Congenital hypogammaglobulinemia (XLA)
279.06	Common variable immune deficiency (CVID)
279.12	Wiskott-Aldrich syndrome
279.20	Severe combined immune deficiency (SCID)
287.30	Idiopathic thrombocytopenic purpura (ITP)
446.10	Kawasaki disease

NDC Codes
NDC	Code	Product Size
GAMMAGARD S/D (5% or 10%)	0944-2620-01	0.5 Grams
	0944-2620-02	2.5 Grams
	0944-2620-03	5.0 Grams
	0944-2620-04	10.0 Grams
GAMMAGARD S/D [Immune Globulin Intravenous (Human)], IgA less than 1 µg/mL in a 5% solution	00944-2655-03	5.0 grams
	00944-2655-04	10.0 grams
GAMMAGARD LIQUID	0944-2700-02	1.0 Grams
	0944-2700-03	2.5 Grams
	0944-2700-04	5.0 Grams
	0944-2700-05	10.0 Grams
	0944-2700-06	20.0 Grams

HCPCS Codes**
Physician Office Billing or Hospital Outpatient Department Billing (HOPPS)	J1566	Injection, Immune Globulin, Intravenous, Lyophilized (e.g. Powder), 500 mg Injection, Immune Globulin, Intravenous, Lyophilized (GAMMAGARD S/D [Immune Globulin Intravenous (Human)], IgA less than 1 µg/mL in a 5% solution)
	J1569*	Injection, Immune Globulin (GAMMAGARD LIQUID), Intravenous, Non-Lyophilized (e.g. Liquid), 500 mg

Administration Codes***
Physician Office Billing or Hospital Outpatient Department Billing* (HOPPS)	90765	IV infusion for therapy, prophylaxis, or diagnosis; initial, up to 1 hour
	90766	IV infusion for therapy, prophylaxis, or diagnosis; each additional hour (List separately in addition to code for primary procedure)
	90767	IV infusion for therapy, prophylaxis, or diagnosis; additional sequential infusion, up to one hour (List separately in addition to code for primary procedure)
	90768	IV infusion for therapy, prophylaxis, or diagnosis; concurrent infusion (List separately in addition to code for primary procedure)
	G0332	Preadministration-related services for intravenous infusion of immunoglobulin, per infusion encounter

*Effective January 1, 2008 CMS added code J1569 specifically for Gammagard Liquid Injection (Inj, Immune Globulin, Gammagard Liquid, IV, Non-Lyophilized, 500MG) for HOPPS and Physician Office Billing. Information released in the
CMS 2008 Final Rule. Information can be retrieved on the CMS website by accessing the following link: www.cms.hhs.gov/QuarterlyProviderUpdates/

**HCPCS Level II codes copyright 2008 Ingenix, Inc. All rights reserved.

***CPT codes copyright 2008 American Medical Association. All Rights Reserved. CPT is a trademark of the AMA. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein.

The information contained in this Coding Reference Guide is provided for informational purposes only. Every reasonable effort has been made to verify the accuracy of the information; however, this guide is not intended to provide specific guidance on how to utilize, code, bill, or charge for any product or service. Healthcare providers should make the ultimate determination as to when to use a specific product based on clinical appropriateness for a particular patient.Third-party payment for medical products and services is affected by numerous factors, and Baxter cannot guarantee success in obtaining insurance payments.

For additional information please contact the Baxter IVIG Reimbursement Helpline at 1-888-229-8379.