D80.5: Immunodeficiency with increased immunoglobulin M [IgM]

Risk adjustment

D80.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 115 Specified Immunodeficiencies and White Blood Cell Disorders0.565 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

D80.5 is named in 27 Medicare coverage policies: 27 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A52507External Infusion Pumps - Policy Article
• A52509Intravenous Immune Globulin - Policy Article
• A54660Billing and Coding: Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home – Medicare Benefit Policy Manual, Chapter 15, 50.6
• A55717Billing and Coding: Lab: Flow Cytometry