C4A.71: Merkel cell carcinoma of right lower limb, including hip

C4A.71, merkel cell carcinoma of right lower limb, including hip, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 59 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 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 C4A.71 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)Special coverage instructions apply—2
J0885Injection, epoetin alfa, (for non-esrd use), 1000 unitsSpecial coverage instructions apply—2
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsSpecial coverage instructions apply—2
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)Special coverage instructions apply—2
J0888Injection, epoetin beta, 1 microgram, (for non esrd use)Special coverage instructions apply—2
Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 unitsSpecial coverage instructions apply—2
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)Special coverage instructions apply—2
J0890Injection, peginesatide, 0.1 mg (for esrd on dialysis)Carrier judgment—2
Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)Special coverage instructions apply—2
Q0512Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day periodSpecial coverage instructions apply—2
Q0511Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day periodSpecial coverage instructions apply—2
G0340Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatmentCarrier judgment—1
G0339Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatmentCarrier judgment—1
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—1
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—1
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—1
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—1
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—1
J8999Prescription drug, oral, chemotherapeutic, nosSpecial coverage instructions apply—1
J8530Cyclophosphamide; oral, 25 mgSpecial coverage instructions apply—1
J8597Antiemetic drug, oral, not otherwise specifiedSpecial coverage instructions apply—1
J8610Methotrexate; oral, 2.5 mgSpecial coverage instructions apply—1
J8498Antiemetic drug, rectal/suppository, not otherwise specifiedSpecial coverage instructions apply—1
Q5110Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgramSpecial coverage instructions apply—1
Q5125Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgramCarrier judgment—1

34 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing C4A.71

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 C4A diagnoses (Merkel cell carcinoma)

Frequently asked questions

Does Medicare cover C4A.71 (Merkel cell carcinoma of right lower limb, including hip)?

Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list C4A.71 as a covered diagnosis for 59 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 C4A.71?

The Level II codes from the policies most specific to this diagnosis are J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 2 articles); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 2 articles); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 2 articles); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 2 articles); J0888 (Injection, epoetin beta, 1 microgram, (for non esrd use), 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list C4A.71?

A59350 (Billing and Coding: Radiation Therapies); A58982 (Billing and Coding: Erythropoiesis Stimulating Agents); A54768 (Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy), and 5 more articles.

What is ICD-10-CM code C4A.71?

C4A.71 is the ICD-10-CM code for merkel cell carcinoma of right lower limb, including hip, in category C4A (Merkel cell carcinoma), chapter 2: Neoplasms.

Next steps

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 2: Neoplasms · All diagnoses · HCPCS lookup