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Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each

CPT4 code

Name of the Procedure:

Common name(s): Subcutaneous Immune Globulin (SCIg) Infusion
Technical/medical terms: Immune globulin, human, for use in subcutaneous infusions, 100 mg, each

Summary

Subcutaneous Immune Globulin (SCIg) Infusion is a medical procedure where a protein product derived from human plasma is administered just under the skin to boost the immune system. This procedure can be managed at home or in a clinical setting and represents a more convenient alternative to intravenous therapy.

Purpose

Medical Condition or Problem:

SCIg is primarily used to treat disorders that affect the body's immune system, such as Primary or Secondary Immunodeficiency.

Goals or Expected Outcomes:
  • Enhance immune system function
  • Reduce frequency and severity of infections
  • Improve overall quality of life for patients with immune deficiencies

Indications

  • Patients with Primary Immunodeficiency (e.g., Common Variable Immune Deficiency, X-linked Agammaglobulinemia)
  • Patients with Secondary Immunodeficiency (e.g., Chronic Lymphocytic Leukemia, Multiple Myeloma)
  • Individuals who experience frequent, severe infections due to compromised immunity

Preparation

Pre-procedure Instructions:
  • Usually, no fasting required
  • Review current medications with a healthcare provider; some adjustments might be necessary
  • Ensure no allergies to immune globulin or its components
Diagnostic Tests or Assessments:
  • Blood tests to assess immune function
  • Possibly skin tests to check for allergic reactions to immune globulin

Procedure Description

  1. Preparation: Wash hands thoroughly, clean the infusion site with antiseptic, and prepare the SCIg solution and infusion equipment.
  2. Site Selection: Choose and rotate infusion sites, typically thighs, abdomen, upper arms, or lower back.
  3. Administration:
    • Insert a small needle under the skin at the chosen site.
    • Connect the tubing to a syringe or a pump.
    • Start the infusion at a controlled, slow rate as determined by your healthcare provider.
  4. Monitoring: Carefully monitor the site and the patient for any adverse reactions during the infusion.
Tools, Equipment, or Technology Used:
  • Syringe or programmable infusion pump
  • Infusion tubing and subcutaneous needles
  • Antiseptics and sterile dressings
Anesthesia or Sedation:
  • Usually, no anesthesia or sedation required
  • Topical anesthetics may be applied to minimize discomfort

Duration

  • The procedure typically takes 1 to 2 hours, depending on the dose and infusion rate.

Setting

  • Can be performed in a hospital, outpatient clinic, or at home under medical supervision.

Personnel

  • Healthcare professionals involved include: nurses, physicians, and pharmacists.
  • When self-administered, patients should be adequately trained by healthcare providers.

Risks and Complications

Common Risks:
  • Redness or swelling at the infusion site
  • Mild headache or fatigue
Rare Risks:
  • Allergic reactions (e.g., rash, itching)
  • Anaphylaxis (severe allergic reaction)
  • Infection at the infusion site
Management:
  • Mild reactions can often be managed with over-the-counter medications.
  • Medical intervention required for severe reactions.

Benefits

  • Improved immune function and reduced infection rates
  • Increased flexibility and convenience, particularly for self-administration at home
  • Enhanced quality of life due to fewer infections and hospital visits

Recovery

Post-procedure Care:
  • Keep the infusion site clean and monitor for signs of infection
  • Hydrate well and rest if feeling fatigued
Expected Recovery Time:
  • Minimal recovery time; most patients can resume normal activities shortly after the infusion
  • Follow-up appointments to monitor immune levels and adjust treatment as needed

Alternatives

Other Treatment Options:
  • Intravenous Immune Globulin (IVIg) therapy
  • Prophylactic antibiotics
  • Stem cell transplant (in severe cases)
Pros and Cons of Alternatives:
  • IVIg: Requires clinic visits, potential for higher rates of systemic side effects.
  • Prophylactic antibiotics: Only target specific infections, possible antibiotic resistance.
  • Stem cell transplant: Potentially curative but carries significant risks and is suitable for a limited patient population.

Patient Experience

During the Procedure:
  • Some discomfort or pain at the needle insertion site
  • Possible stinging or burning sensation as the solution is infused
After the Procedure:
  • Mild to moderate swelling or redness at the infusion site
  • Fatigue or headache, which generally resolve with rest and hydration
Pain Management and Comfort Measures:
  • Topical anesthetics for needle insertion
  • Over-the-counter pain relievers for headache or mild discomfort

Overall, SCIg represents a practical and effective treatment option for patients with compromised immunity, offering flexibility and reduced complications compared to other methods.

Medical Policies and Guidelines for Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each

Related policies from health plans

Immunoglobulins

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