C86.41: Blastic NK-cell lymphoma, in remission

C86.41, blastic NK-cell lymphoma, in remission, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 62 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 C86.41 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
J9267Injection, paclitaxel, 1 mgSpecial coverage instructions apply—1
J9264Injection, paclitaxel protein-bound particles, 1 mgCarrier 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
Q5130Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mgCarrier judgment—1
J2820Injection, sargramostim (gm-csf), 50 mcgSpecial coverage instructions apply—1
Q5120Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mgCarrier judgment—1
Q5148Injection, filgrastim-txid (nypozi), biosimilar, 1 microgramSpecial coverage instructions apply—1

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

Medicare policy articles listing C86.41

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 C86 diagnoses (Other specified types of T/NK-cell lymphoma)

Frequently asked questions

Does Medicare cover C86.41 (Blastic NK-cell lymphoma, in remission)?

Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list C86.41 as a covered diagnosis for 62 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 C86.41?

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); J9267 (Injection, paclitaxel, 1 mg, 1 article); J9264 (Injection, paclitaxel protein-bound particles, 1 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C86.41?

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 C86.41?

A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A52479 (Oral Anticancer Drugs - Policy Article), and 4 more articles.

What is ICD-10-CM code C86.41?

C86.41 is the ICD-10-CM code for blastic NK-cell lymphoma, in remission, in category C86 (Other specified types of T/NK-cell 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