C13.9: Malignant neoplasm of hypopharynx, unspecified
C13.9, malignant neoplasm of hypopharynx, unspecified, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 55 HCPCS Level II codes, including J0585 (Injection, onabotulinumtoxina, 1 unit), J9267 (Injection, paclitaxel, 1 mg), J9264 (Injection, paclitaxel protein-bound particles, 1 mg). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 4 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 C13.9 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 1 |
| J9267 | Injection, paclitaxel, 1 mg | Special coverage instructions apply | — | 1 |
| J9264 | Injection, paclitaxel protein-bound particles, 1 mg | Carrier judgment | — | 1 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 1 |
| J8999 | Prescription drug, oral, chemotherapeutic, nos | Special coverage instructions apply | — | 1 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | Special coverage instructions apply | — | 1 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | Special coverage instructions apply | — | 1 |
| J8530 | Cyclophosphamide; oral, 25 mg | Special coverage instructions apply | — | 1 |
| J8597 | Antiemetic drug, oral, not otherwise specified | Special coverage instructions apply | — | 1 |
| J8610 | Methotrexate; oral, 2.5 mg | Special coverage instructions apply | — | 1 |
| J8498 | Antiemetic drug, rectal/suppository, not otherwise specified | Special coverage instructions apply | — | 1 |
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 1 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 1 |
30 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C13.9
- A56389: Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34434
- A52450: Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) (Wellpoint Federal (MAC - Part A, MAC - Part B); 2 Level II codes)
- A56805: Billing and Coding: Magnetic Resonance Angiography (MRA) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 12 Level II codes). LCD with the same title: L33633, L34372, L34865
- A52479: Oral Anticancer Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 8 Level II codes). LCD with the same title: L33826
- 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
- A56748: Billing and Coding: White Cell Colony Stimulating Factors (Palmetto GBA (MAC - Part A, MAC - Part B); 16 Level II codes). LCD with the same title: L37176
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
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 C13 diagnoses (Malignant neoplasm of hypopharynx)
- C13.0 — Malignant neoplasm of postcricoid region
- C13.1 — Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect
- C13.2 — Malignant neoplasm of posterior wall of hypopharynx
- C13.8 — Malignant neoplasm of overlapping sites of hypopharynx
Frequently asked questions
Does Medicare cover C13.9 (Malignant neoplasm of hypopharynx, unspecified)?
Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list C13.9 as a covered diagnosis for 55 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 C13.9?
The Level II codes from the policies most specific to this diagnosis are J0585 (Injection, onabotulinumtoxina, 1 unit, 1 article); J9267 (Injection, paclitaxel, 1 mg, 1 article); J9264 (Injection, paclitaxel protein-bound particles, 1 mg, 1 article); C8900 (Magnetic resonance angiography with contrast, abdomen, 1 article); C8901 (Magnetic resonance angiography without contrast, abdomen, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with C13.9?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list C13.9?
A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A56805 (Billing and Coding: Magnetic Resonance Angiography (MRA)), and 4 more articles.
What is ICD-10-CM code C13.9?
C13.9 is the ICD-10-CM code for malignant neoplasm of hypopharynx, unspecified, in category C13 (Malignant neoplasm of hypopharynx), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J0585
- Watch J0585 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0585
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.