C38.0: Malignant neoplasm of heart
C38.0, malignant neoplasm of heart, is listed as a covered diagnosis in 17 Medicare billing and coding articles that apply to 76 HCPCS Level II codes, including C8925 (Transesophageal echocardiography (tee) with contrast, or…), C8926 (Transesophageal echocardiography (tee) with contrast, or…), C8927 (Transesophageal echocardiography (tee) with contrast, or…). The articles come from 5 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 C38.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| C8925 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 4 |
| C8926 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 4 |
| C8927 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis | Special coverage instructions apply | — | 4 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 4 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 4 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 4 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 4 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 4 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 3 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 3 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 3 |
| 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 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 3 |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | Carrier judgment | — | 2 |
| G0269 | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) | Special coverage instructions apply | — | 2 |
| 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 |
| 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 | — | 2 |
| 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 | — | 2 |
51 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C38.0
- A57179: Billing and Coding: Transesophageal Echocardiogram (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33756
- A56809: Billing and Coding: Transesophageal Echocardiography (TEE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56500: Billing and Coding: Cardiac Catheterization and Coronary Angiography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- A52850: Billing and Coding: Cardiac Catheterization and Coronary Angiography (Wellpoint Federal (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- A59350: Billing and Coding: Radiation Therapies (Palmetto GBA (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L39553
- A52868: Billing and Coding: Transesophageal Echocardiography (TEE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes)
- 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
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- 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
2 more articles list C38.0.
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 C38 diagnoses (Malignant neoplasm of heart, mediastinum and pleura)
- C38.1 — Malignant neoplasm of anterior mediastinum
- C38.2 — Malignant neoplasm of posterior mediastinum
- C38.3 — Malignant neoplasm of mediastinum, part unspecified
- C38.4 — Malignant neoplasm of pleura
- C38.8 — Malignant neoplasm of overlapping sites of heart, mediastinum and…
Frequently asked questions
Does Medicare cover C38.0 (Malignant neoplasm of heart)?
Medicare covers items and services, not diagnoses. 17 Medicare billing and coding articles list C38.0 as a covered diagnosis for 76 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 C38.0?
The Level II codes from the policies most specific to this diagnosis are C8925 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles); C8926 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles); C8927 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles); J0461 (Injection, atropine sulfate, 0.01 mg, 4 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 4 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list C38.0?
A57179 (Billing and Coding: Transesophageal Echocardiogram); A56809 (Billing and Coding: Transesophageal Echocardiography (TEE)); A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)), and 14 more articles.
What is ICD-10-CM code C38.0?
C38.0 is the ICD-10-CM code for malignant neoplasm of heart, in category C38 (Malignant neoplasm of heart, mediastinum and pleura), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under C8925
- Watch C8925 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for C8925
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.