What is RhoGAM? /*margin-bottom: 43px;*/ Transpl Int. Aetna considers hepatitis B immune globulin medically necessary for members who have had contact with an individual diagnosed with hepatitis B virus (HBV). The maximum dose of 625 IU (5 vials) should be administered for all patients greater than 40 kilograms in weight. Winrho SDF; Winrho SDF; Descriptions. Work-related injuries may be covered by the employer's workman's compensation benefit plan. @media print { All 36 included trials originated from China and were at overall high risk of bias. The treatment of pregnant women with CMV-HIG has shown promising results. OL OL OL OL LI { 24th ed. Aetna considers hepatitis A immune globulin experimental and investigational for other indications because of insufficient evidence of safety and effectiveness. Centers for Disease Control and Prevention (CDC). Matysiak-Klose and associates (2018) noted that passive immunization with Igs as PEP following contact with measles is recommended by the German Standing Committee on Vaccination (STIKO) especially for un-protected individuals at high risk of complications for whom active immunization is contraindicated, such as infants of less than 6 months of age, immuno-compromised patients and pregnant women. It was designated as an orphan drug by the FDA and received a priority review. Arnon et al (2006) created the orphan drug Human Botulism Immune Globulin Intravenous (Human) (BIG-IV), which neutralizes botulinum toxin, and evaluated its safety and efficacy in treating infant botulism, the intestinal-toxemia form of human botulism. Visit cvs.com … This Clinical Policy Bulletin may be updated and therefore is subject to change. 2014;58(1):1-10. The usual dose is a single IM injection administered within 2 weeks of exposure. If you think somebody is violating your copyrights and want to notify us, you can find information Furthermore, the antibody response was inadequate in some cases following full PEP administration according to the Belgian recommendation. Immune globulin NONE X X X X X Code closed 3/31/13. Gajarski RJ. Varicella (Chickenpox). Cytomegalovirus immune globulin (CMVIG) prophylaxis is associated with increased survival after orthotopic liver transplantation. HCPCS Code Description: Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) If Varicella-Zoster Immune Globulin (Human) is unavailable, GamaSTAN S/D at a dose of 0.6 to 1.2 mL/kg, promptly given, may also modify varicella. Varizig is supplied as a sterile solution for intramuscular injection and is available in a single‐use vial of 125 IU in 1.2 mL. Specifically, in liver transplant patients combination with ganciclovir significantly decreased the incidence of severe CMV infection from 28% to 5% when compared to monotherapy with CMV immune globulin. IGIM should not be given with measles vaccine. text-decoration: line-through; American College of Obstetricians and Gynecologists. Use of smallpox (vaccinia) vaccine, June 2002. Aetna considers post-exposure prophylaxis with varicella zoster immune globulin (VariZIG) as soon as possible within 10 days after exposure to a person with varicella or shingles medically necessary for HIV positive individuals who are susceptible to varicella zoster virus (those who have not been vaccinated, have no history of varicella or herpes zoster, or are seronegative for varicella zoster virus). Number identifying a section of the Medicare carriers manual. UpToDate [online serial]. Rabies immune globulin is indicated for treatment of rabies exposure where the animal has escaped or is known to be rabid at the time of direct exposure or attack. Soentjens and associates (2019) noted that data on RPEP and the use of human rabies immunoglobulins (HRIG) in Belgium are scarce. Hepatitis A immune globulin is indicated for persons who are exposed or likely to be exposed to hepatitis A virus (HAV). The authors concluded that the use of Botulism Immune Globulin Intravenous significantly decreased the length of ICU stay, length of mechanical ventilation, and overall hospital stay in children with infant botulism. Soentjens P, Croughs M, Burm C, et al. Is lamivudine with 1-week HBlg as effective as long-term high-dose HBlg in HBV prophylaxis after liver transplantation? It is effective for treatment of eczema vaccinatum and certain cases of progressive vaccinia; it might be useful also in the treatment of ocular vaccinia resulting from inadvertent implantation. 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