D81.4: Nezelof's syndrome
D81.4, Nezelof's syndrome, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 23 HCPCS Level II codes, including J1569 (Injection, immune globulin, (gammagard liquid/gammagard…), J1561 (Injection, immune globulin, (gamunex-c/gammaked)…), J1459 (Injection, immune globulin (privigen), intravenous…). The articles come from 6 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with D81.4 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J1569 | Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg | Special coverage instructions apply | — | 3 |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 3 |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 3 |
| J1576 | Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 3 |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 3 |
| J1556 | Injection, immune globulin (bivigam), 500 mg | Carrier judgment | — | 3 |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 3 |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | Special coverage instructions apply | — | 3 |
| J1554 | Injection, immune globulin (asceniv), 500 mg | Carrier judgment | — | 3 |
| J1552 | Injection, immune globulin (alyglo), 500 mg | Carrier judgment | — | 3 |
| J1559 | Injection, immune globulin (hizentra), 100 mg | Carrier judgment | — | 2 |
| J1555 | Injection, immune globulin (cuvitru), 100 mg | Carrier judgment | — | 2 |
| J1575 | Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin | Carrier judgment | — | 2 |
| J1558 | Injection, immune globulin (xembify), 100 mg | Carrier judgment | — | 2 |
| J1551 | Injection, immune globulin (cutaquig), 100 mg | Carrier judgment | — | 2 |
| J1572 | Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 2 |
| J1553 | Injection, immune globulin (yimmugo), 100 mg | Carrier judgment | — | 2 |
| J1577 | Injection, immune globulin (qivigy), 100 mg | Carrier judgment | — | 2 |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | Carrier judgment | — | 4 |
| U0001 | Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel | Carrier judgment | — | 4 |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | Carrier judgment | — | 1 |
| J2791 | Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu | Special coverage instructions apply | — | 1 |
| J2792 | Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu | Special coverage instructions apply | — | 1 |
Medicare policy articles listing D81.4
- A56786: Billing and Coding: Immune Globulin (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34007, L35093
- A57778: Billing and Coding: Immune Globulin (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34007, L35093
- A56718: Billing and Coding: Intravenous Immunoglobulin (IVIG) (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L34580
- A58710: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A58720: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A58761: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
- A58747: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L38988, L39001, L39038, L39044
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other D81 diagnoses (Combined immunodeficiencies)
- D81.0 — Severe combined immunodeficiency [SCID] with reticular dysgenesis
- D81.1 — Severe combined immunodeficiency [SCID] with low T- and B-cell numbers
- D81.2 — Severe combined immunodeficiency [SCID] with low or normal B-cell…
- D81.30 — Adenosine deaminase deficiency, unspecified
- D81.31 — Severe combined immunodeficiency due to adenosine deaminase deficiency
- D81.32 — Adenosine deaminase 2 deficiency
- D81.39 — Other adenosine deaminase deficiency
- D81.5 — Purine nucleoside phosphorylase [PNP] deficiency
- D81.6 — Major histocompatibility complex class I deficiency
- D81.7 — Major histocompatibility complex class II deficiency
- D81.810 — Biotinidase deficiency
- D81.818 — Other biotin-dependent carboxylase deficiency
- D81.819 — Biotin-dependent carboxylase deficiency, unspecified
- D81.82 — Activated Phosphoinositide 3-kinase Delta Syndrome [APDS]
- D81.89 — Other combined immunodeficiencies
- D81.9 — Combined immunodeficiency, unspecified
Frequently asked questions
Does Medicare cover D81.4 (Nezelof's syndrome)?
Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list D81.4 as a covered diagnosis for 23 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 D81.4?
The Level II codes from the policies most specific to this diagnosis are J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 3 articles); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 3 articles); J1459 (Injection, immune globulin (privigen), intravenous…, 3 articles); J1576 (Injection, immune globulin (panzyga), intravenous…, 3 articles); J1557 (Injection, immune globulin, (gammaplex), intravenous…, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list D81.4?
A56786 (Billing and Coding: Immune Globulin); A57778 (Billing and Coding: Immune Globulin); A56718 (Billing and Coding: Intravenous Immunoglobulin (IVIG)), and 4 more articles.
What is ICD-10-CM code D81.4?
D81.4 is the ICD-10-CM code for Nezelof's syndrome, in category D81 (Combined immunodeficiencies), chapter 3: Diseases of the blood and immune mechanism.
Next steps
- Run a reimbursement report for a device billed under J1569
- Watch J1569 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1569
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 3: Diseases of the blood and immune mechanism · All diagnoses · HCPCS lookup