Mitchsfm@mitchsfm
Hello Mitch
So sorry to hear you are having difficulties with Medicare approval for IgG infusion therapy for CIDP.
I was diagnosed with CIDP in 2021
and have been getting IgG infusions every two weeks since. I have to say my neurologist explained that Medicare requires steroid therapy or an alternative therapy to be started first and if not successful then they will approve IgG.
You mention that there was no definitive test for the diagnosis of CIDP, and I agree there is not one test that will say yes you have CIDP.
However, there are criteria they use to make the diagnosis, 1: demyelination on electro-conduction studies, 2: lumbar puncture studies that show high protein levels and low WBC counts, and 3: absent deep tendon reflexes in the affected limb.
The facility that I receive my infusions also charge around $16,000 per treatment and Medicare pays 80% and our secondary pays the remaining cost.
I would suggest calling Medicare yourself and find out why they denied your coverage and if they approve what would they pay. Also, I would revisit the medical billing department that submitted the request for approval and verify that it was submitted correctly. Please keep us informed and let the group know if there is anything we can do to help.
Kim