C69.80: Malignant neoplasm of overlapping sites of unspecified eye and adnexa

C69.80, malignant neoplasm of overlapping sites of unspecified eye and adnexa, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 29 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). 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 C69.80 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
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
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—1
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—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
Q5101Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgramSpecial coverage instructions apply—1
J1442Injection, filgrastim (g-csf), excludes biosimilars, 1 microgramSpecial coverage instructions apply—1
J1449Injection, eflapegrastim-xnst, 0.1 mgCarrier judgment—1
J1447Injection, tbo-filgrastim, 1 microgramSpecial coverage instructions apply—1
Q5108Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mgCarrier judgment—1
Q5111Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mgCarrier judgment—1
Q5127Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mgCarrier judgment—1
J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mgCarrier judgment—1
Q5122Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mgCarrier judgment—1
Q5130Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mgCarrier judgment—1
J2820Injection, sargramostim (gm-csf), 50 mcgSpecial coverage instructions apply—1

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

Medicare policy articles listing C69.80

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 C69 diagnoses (Malignant neoplasm of eye and adnexa)

Frequently asked questions

Does Medicare cover C69.80 (Malignant neoplasm of overlapping sites of unspecified eye…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list C69.80 as a covered diagnosis for 29 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 C69.80?

The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 1 article); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 1 article); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 1 article); J0280 (Injection, aminophyllin, up to 250 mg, 1 article); J1245 (Injection, dipyridamole, per 10 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list C69.80?

A54768 (Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy); A52479 (Oral Anticancer Drugs - Policy Article); A56748 (Billing and Coding: White Cell Colony Stimulating Factors).

What is ICD-10-CM code C69.80?

C69.80 is the ICD-10-CM code for malignant neoplasm of overlapping sites of unspecified eye and adnexa, in category C69 (Malignant neoplasm of eye and adnexa), 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