C81.4A: Lymphocyte-rich Hodgkin lymphoma, in remission

C81.4A, lymphocyte-rich Hodgkin lymphoma, in remission, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 68 HCPCS Level II codes, including Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…), J0585 (Injection, onabotulinumtoxina, 1 unit). 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 3 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 C81.4A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
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
J0585Injection, onabotulinumtoxina, 1 unitSpecial coverage instructions apply—1
J9312Injection, rituximab, 10 mgSpecial coverage instructions apply—1
Q5123Injection, rituximab-arrx, biosimilar, (riabni), 10 mgCarrier judgment—1
Q5119Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mgCarrier judgment—1
Q5115Injection, rituximab-abbs, biosimilar, (truxima), 10 mgSpecial coverage instructions apply—1
J9311Injection, rituximab 10 mg and hyaluronidaseSpecial coverage instructions apply—1
J3590Unclassified biologicsCarrier judgment—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
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

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

Medicare policy articles listing C81.4A

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 C81 diagnoses (Hodgkin lymphoma)

Frequently asked questions

Does Medicare cover C81.4A (Lymphocyte-rich Hodgkin lymphoma, in remission)?

Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list C81.4A as a covered diagnosis for 68 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 C81.4A?

The Level II codes from the policies most specific to this diagnosis are Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles); Q0511 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles); J0585 (Injection, onabotulinumtoxina, 1 unit, 1 article); J9312 (Injection, rituximab, 10 mg, 1 article); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C81.4A?

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 C81.4A?

A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A56380 (Billing and Coding: Rituximab); A52479 (Oral Anticancer Drugs - Policy Article), and 5 more articles.

What is ICD-10-CM code C81.4A?

C81.4A is the ICD-10-CM code for lymphocyte-rich Hodgkin lymphoma, in remission, in category C81 (Hodgkin lymphoma), 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