B19.21: Unspecified viral hepatitis C with hepatic coma
B19.21, unspecified viral hepatitis C with hepatic coma, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 9 HCPCS Level II codes, including J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use)), J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units), Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…). The articles come from 3 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 B19.21 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 3 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 3 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 3 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 3 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 3 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 2 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
Medicare policy articles listing B19.21
- A56795: Billing and Coding: Erythropoiesis Stimulating Agents (ESAs) (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34633
- A56462: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L34356
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
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 B19 diagnoses (Unspecified viral hepatitis)
- B19.20 — Unspecified viral hepatitis C without hepatic coma
Frequently asked questions
Does Medicare cover B19.21 (Unspecified viral hepatitis C with hepatic coma)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list B19.21 as a covered diagnosis for 9 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 B19.21?
The Level II codes from the policies most specific to this diagnosis are J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 3 articles); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 3 articles); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 3 articles); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 3 articles); Q5105 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list B19.21?
A56795 (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)); A56462 (Billing and Coding: Erythropoiesis Stimulating Agents (ESA)); A60381 (Billing and Coding: Erythropoiesis Stimulating Agents).
What is ICD-10-CM code B19.21?
B19.21 is the ICD-10-CM code for unspecified viral hepatitis C with hepatic coma, in category B19 (Unspecified viral hepatitis), chapter 1: Certain infectious and parasitic diseases.
Next steps
- Run a reimbursement report for a device billed under J0881
- Watch J0881 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0881
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 1: Certain infectious and parasitic diseases · All diagnoses · HCPCS lookup