HCPCS Code J1562: Injection, immune globulin (Vivaglobin), 100 mg

Key takeaways

HCPCS Code J1562 described injection, immune globulin (Vivaglobin), 100 mg — a subcutaneous immunoglobulin product billed under Medicare Part B J-codes.

J1562 is a deleted code and cannot be used for current billing. AAPC lists a termination date of December 31, 2025.

No single code replaced it. Seven active codes cover subcutaneous immune globulin products, and the right one depends on the brand administered.

J1563 and J1564 are also deleted and were superseded by Q-codes in 2006. Neither is a valid code for Gammagard S/D, which bills under J1566.

Practice management software like Pabau supports HCPCS code entry and drug injection billing, so infusion practices submit fewer mismatched J-codes.

HCPCS Code J1562 described injection, immune globulin (Vivaglobin), 100 mg, and it is now a deleted code. No single replacement was ever issued for it. Seven product-specific subcutaneous codes cover the ground it held, and the right one depends on the brand administered.

This guide covers the full billing picture for the code. You get what it described, when it was deleted, and which active codes replace it.

It also sets out the ICD-10 diagnosis codes, documentation rules, and Medicare billing rules that apply. And it names the three immune globulin codes coders most often confuse, so a legacy record does not become a denied claim.

HCPCS Code J1562: Definition and clinical context

HCPCS Code J1562 covered the injection of immune globulin under the brand name Vivaglobin, billed per 100 mg. It fell under the HCPCS Level II J-code category. That is the CMS code set for drugs given by a route other than the mouth, which covers intravenous, subcutaneous, and intramuscular injections.

Vivaglobin was a 16% subcutaneous human immunoglobulin G (IgG) solution from CSL Behring, indicated for primary immunodeficiency (PI) diseases.

Subcutaneous immune globulin (SCIG) differs from intravenous formulations in both administration route and clinical setting. SCIG products like Vivaglobin were designed for self-administration or home infusion.

That made them significant for primary immunodeficiency patients who need frequent, ongoing replacement therapy. The 100 mg billing unit matched how payers tracked quantity across infusion sessions. A single session could involve many units, depending on the prescribed dose.

J1562 at a glance: Code details table

Code status: Is J1562 a deleted HCPCS code?

Yes. HCPCS Code J1562 is a deleted code and is not valid on current claims. AAPC’s deleted-code index lists a termination date of December 31, 2025, which makes January 1, 2026 the first service date where the code is invalid.

Submitting a deleted HCPCS code triggers rejection at the clearinghouse or payer level. Payers validate every code against the active code set for that date of service.

Vivaglobin itself was withdrawn from the US market by CSL Behring years before the code was retired. When a drug product is discontinued, CMS eventually retires the associated J-code and directs billers to product-specific codes.

That is what happened across the whole subcutaneous immune globulin category. Instead of one universal successor, CMS assigned an individual code to each SCIG product on the market. The correct code now depends entirely on the brand administered.

• Do not bill J1562 for any service date on or after January 1, 2026. Payers will reject it.
• For legacy claims or audits, confirm the original service date and the product administered before you judge whether the historical code was correct.
• For current services, identify the specific product dispensed and use the matching active J-code from the tables below.

J1562 replacement codes: What to use instead

There is no single HCPCS Code J1562 replacement. Seven active codes cover subcutaneous immune globulin products, each tied to a specific brand.

CMS Local Coverage Article A57778 lists this set as the codes that support medical necessity for subcutaneous immune globulin. Choose from these first, because J1562 was itself a subcutaneous code.

Two codes in that table cover products licensed for either route. J1561 and J1569 therefore need a route modifier. Use JA for an intravenous infusion and JB for a subcutaneous injection. Omitting it on a dual-route code is a routine denial reason. That is easy to miss when a patient moves from in-office IV to home subcutaneous therapy.

For a practice transitioning a patient off Vivaglobin, J1559 (Hizentra) is the closest functional analogue. It is a CSL Behring subcutaneous IgG formulation billed per 100 mg, matching the route and unit structure of J1562.

Even so, the code must reflect the product actually administered, not the historical one. Verify the brand against the infusion record before you code the claim.

Intravenous and intramuscular codes that get picked by mistake

The codes below sit next to the subcutaneous set in the J-code range and get selected by mistake. None of them replaces J1562, because none is a subcutaneous-only product code. They matter for a different reason. A mismatch between route and code is one of the most common immune globulin denials.

Two of those rows are the easiest to mis-pick. J1459 is a CSL Behring product like Hizentra, but it is intravenous, so it never stands in for a subcutaneous code. J1460 covers the same intramuscular gamma globulin as J1560 at a 1 cc dose, so those two split on volume rather than product.

J1566 deserves particular attention. It is a not-otherwise-specified code for lyophilized intravenous immune globulin, so more than one powdered product bills under it.

Gammagard S/D is the product coders most often need it for. Because it is an NOS code, payers expect the NDC and product name in the claim detail to identify what was actually given.

Deleted immune globulin codes you may see in legacy records

Three codes in this family are retired. They appear in old claim histories and in outdated crosswalk tables, which is how they end up on new claims by accident.

• J1562 (Vivaglobin, 100 mg). Deleted, with a termination date of December 31, 2025 per AAPC. Replaced by the product-specific subcutaneous codes above.
• J1563 (immune globulin, intravenous, 1 g). Medicare stopped paying it on April 1, 2005 and it was deleted effective January 1, 2006. It was superseded by Q9941 and Q9943, which were themselves later replaced by product-specific J-codes. It has never been the code for Gammagard S/D.
• J1564 (immune globulin, intravenous, 10 mg). Deleted on the same date as J1563, superseded by Q9942 and Q9944. It is not the Cuvitru code, despite appearing that way in several third-party crosswalks. Cuvitru bills under J1555.

The lesson from all three is the same. Verify a J-code against the current CMS HCPCS release or the relevant Local Coverage Article before you trust a crosswalk you did not build.

Medicare billing guidelines for HCPCS Code J1562

When J1562 was active, Medicare Part B covered immune globulin administration under the outpatient drug benefit. The billing rules for subcutaneous immune globulin carry over to the replacement codes, so they still explain how the category is handled.

According to CMS fee schedule guidance, immune globulin J-codes are paid on the Average Sales Price (ASP) methodology. That is ASP plus a percentage add-on that varies by policy period.

Key billing rules that applied to J1562, and that continue to govern its replacement codes, include the following:

• Units of service: Bill in the unit size defined by the code, not by the product. J1559 and J1555 bill per 100 mg, while J1561 and J1569 bill per 500 mg. Round to the nearest whole unit under CMS rounding policy.
• Route modifiers: Codes covering both routes, such as J1561 and J1569, require modifier JA for intravenous infusion or JB for subcutaneous injection.
• Place of service: Outpatient hospital (POS 22) and physician office (POS 11) both apply. Home infusion may follow a different pathway depending on whether Part B or Part D governs.
• Bill type codes: Facility claims use bill type 13X for hospital outpatient. Professional claims for the office setting go on the CMS-1500.
• Ordering physician: A physician order is required, and the prescribing clinician’s NPI must appear on the claim.
• NDC reporting: Most payers require the 11-digit NDC alongside the J-code, and NOS codes such as J1566 always do.

For practices running infusion services alongside other workflows, checking which clinicians can administer IV therapy by state comes before any immune globulin protocol. Scope-of-practice rules affect both clinical delivery and billing compliance.

Medicare reimbursement for J1562

J1562 was reimbursed under Medicare Part B using the ASP-based drug payment methodology. Part B drugs in the J-code series are paid at ASP plus an add-on percentage, historically 6% and subject to sequestration adjustments.

Because J1562 is now deleted, no current ASP rate applies to it. Any rate you find published against the code is historical only.

For current reimbursement data on the active codes, use the CMS ASP quarterly pricing files. CMS publishes them on its website and updates them every quarter. The codes to look up are J1551, J1555, J1558, J1559, J1561, J1569, and J1575 for subcutaneous products.

Add J1459, J1566, J1568, and J1572 if the practice also runs intravenous infusions. SCIG rates move meaningfully with ASP, which is why quarterly checks are standard in infusion billing.

In an outpatient infusion setting, the Medicare drug payment covers the product only. Administration is billed separately, with 96365 for the first hour of a non-chemotherapy infusion.

A single subcutaneous or intramuscular injection is reported with 96372 instead. Bundling the drug cost into an administration code, or the reverse, is a common audit trigger.

ICD-10 codes that support medical necessity

Immune globulin administration requires an ICD-10-CM diagnosis code that supports medical necessity. The clinical indications for Vivaglobin and its successors center on primary and secondary immunodeficiency, where IgG replacement is clinically warranted.

CMS Local Coverage Article A57778 carries the authoritative list of covered diagnosis codes for immune globulin billing.

The core diagnosis codes that support medical necessity for immune globulin replacement therapy are set out below.

Always confirm the ICD-10-CM codes accepted by your MAC against Local Coverage Article A57778. The codes above are the core covered diagnoses, and the full article may add secondary immunodeficiency conditions.

Do not use D89.9 in place of a more specific diagnosis when one exists. Payers generally require the most specific code available to support medical necessity.

Practices running infusion therapy across several specialties should read the IV therapy licensing rules alongside their ICD-10 mapping. That matters most when building protocols for immunodeficiency patients.

Documentation requirements for immune globulin billing

Claims for immune globulin administration face heightened scrutiny in Medicare audits. Missing or inadequate documentation is the leading reason for post-payment recoupment in this category.

The clinical record has to support every element of the claim. That means the diagnosis, the medical necessity decision, the product, the dose, and the administration event.

Required documentation for immune globulin claims includes the following elements, consistent with CMS LCA A57778 guidance:

• Diagnosis documentation: The chart must carry a confirmed diagnosis matching the ICD-10-CM code billed. Lab values confirming IgG deficiency, such as serum IgG levels, strengthen the record considerably.
• Medical necessity justification: A physician note explaining why immune globulin replacement is clinically indicated for this patient. For new orders this is usually the initial consultation note or immunology workup.
• Prescription or order: A signed physician order specifying product, dose, route, and frequency, with the prescribing clinician’s NPI documented.
• Infusion administration record: Date of service, product name and lot number, dose in mg, start and stop times, administration site, and any adverse reactions.
• Nursing or clinical notes: Evidence of patient monitoring during and after administration, especially for the first few infusions.
• Quantity verification: Units billed must match the dose given. Divide total milligrams by the code’s unit size, which is 100 mg for J1559 and 500 mg for J1569.

Digital documentation tools reduce the risk of incomplete records. Practices using digital clinical documentation forms can build structured infusion logs that capture every required field by default, which makes an omission much harder.

For practices that manage home infusion referrals alongside in-office administration, the product and dose must be documented consistently across every encounter type. Inconsistency between the prescription, the infusion record, and the claim is a common audit trigger.

IV therapy intake documentation gives a practical starting point for building infusion records that capture billing-critical data from the first visit.

Common J1562 coding errors and how to avoid them

Immune globulin denials cluster around a handful of repeatable mistakes. Each one is preventable at the point of claim entry, which is where a check costs minutes rather than months.

• Billing a deleted code from a legacy template. J1562, J1563, and J1564 all live on in old superbills and saved claim templates. Retire them in your system rather than relying on memory.
• Carrying the code forward when the product changes. A patient switched from Hizentra to Cuvitru moves from J1559 to J1555. The unit size happens to match, so the error survives a quick review.
• Mixing up unit sizes. A 500 mg code billed as though it were a 100 mg code overstates units fivefold and reads as an overpayment in audit.
• Dropping the JA or JB modifier on a dual-route code such as J1561 or J1569.
• Omitting the NDC on an NOS code such as J1566, which leaves the payer unable to identify the product.
• Trusting a third-party crosswalk. Several published tables still map J1563 to Gammagard S/D and J1564 to Cuvitru. Both mappings are wrong.

AAPC’s index of HCPCS Level II codes and the current CMS HCPCS release are the two sources to confirm code status against. Practices administering immune globulin should review both at least annually, alongside the quarterly ASP pricing updates.

Mobile and home infusion add a wrinkle, because coding accuracy then depends on records that travel with the patient. The rules for mobile IV therapy records apply to immune globulin exactly as they apply to hydration.

How Pabau supports immune globulin billing workflows

Every immune globulin claim has to line up four things:

• the code that matches the product administered
• the unit count that matches the dose given
• the JA or JB modifier where the code covers both routes
• an infusion record that supports all three

One mismatch between the product given and the code submitted is enough to trigger a denial. Practice management software like Pabau keeps all four in the same place. Pabau’s claims management software supports HCPCS code entry and drug injection billing inside the claim submission process.

For practices administering subcutaneous immune globulin alongside other infusion therapies, Pabau connects clinical documentation directly to the billing workflow. Treatment records, administered doses, and prescribing physician details captured during the encounter feed straight into the claim.

That removes the manual transcription step where J-code mismatches usually start. Pabau’s IV therapy EMR software carries that trail end to end, from the physician order through to the submitted claim.

Practices building or scaling an infusion program need documentation and billing tools that stay joined up across multiple products. Pabau’s infusion center software keeps the order, the administration record, and the claim on one patient timeline.

Pabau’s prescription management software maintains the ordered-product trail that Medicare auditors look for when they review infusion claims.

Simplify drug injection billing with Pabau

Pabau connects clinical documentation to HCPCS claim submission. Infusion practices make fewer coding errors and send cleaner claims for immune globulin and other injectable therapies.

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Conclusion

The deleted code is the easy half of this problem. The harder half is the assumption that one replacement exists. Seven active codes cover subcutaneous immune globulin today, and the right one turns on the brand administered and the route used.

So the habit worth building is a small one. Read the product off the infusion record before you pick the code, then check that code against the current CMS release before you submit.

Those two steps catch the dual-route modifier, and they catch the crosswalks that still map J1563 and J1564 to the wrong products. Book a demo to see how Pabau ties administered-product documentation to J-code claim entry.

Continue your research

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Working across the wider J-code range? J1631 applies the same product-to-code discipline to long-acting haloperidol decanoate.

Managing infusion billing across several products? IV therapy EMR guide compares platforms that tie clinical documentation to HCPCS claim submission.

Setting up a compliant infusion practice? Opening an infusion practice outlines the licensing, clinical, and operational requirements.

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