C39.0: Malignant neoplasm of upper respiratory tract, part unspecified
C39.0, malignant neoplasm of upper respiratory tract, part unspecified, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 42 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 2 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 C39.0 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 | — | 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 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 1 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 1 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 1 |
| Q5110 | Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram | Special coverage instructions apply | — | 1 |
| Q5125 | Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram | Carrier judgment | — | 1 |
| Q5101 | Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram | Special coverage instructions apply | — | 1 |
| J1442 | Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram | Special coverage instructions apply | — | 1 |
| J1449 | Injection, eflapegrastim-xnst, 0.1 mg | Carrier judgment | — | 1 |
| J1447 | Injection, tbo-filgrastim, 1 microgram | Special coverage instructions apply | — | 1 |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5127 | Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5130 | Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| J2820 | Injection, sargramostim (gm-csf), 50 mcg | Special coverage instructions apply | — | 1 |
| Q5120 | Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5148 | Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram | Special coverage instructions apply | — | 1 |
| Q5169 | Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg | Carrier judgment | — | 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 |
17 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C39.0
- 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
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 C39 diagnoses (Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs)
- C39.9 — Malignant neoplasm of lower respiratory tract, part unspecified
Frequently asked questions
Does Medicare cover C39.0 (Malignant neoplasm of upper respiratory tract, part…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list C39.0 as a covered diagnosis for 42 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 C39.0?
The Level II codes from the policies most specific to this diagnosis are J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 1 article); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 1 article); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 1 article); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 1 article); Q5105 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list C39.0?
A56462 (Billing and Coding: Erythropoiesis Stimulating Agents (ESA)); A56748 (Billing and Coding: White Cell Colony Stimulating Factors); A52480 (Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article).
What is ICD-10-CM code C39.0?
C39.0 is the ICD-10-CM code for malignant neoplasm of upper respiratory tract, part unspecified, in category C39 (Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs), chapter 2: Neoplasms.
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.