C88.00: Waldenstrom macroglobulinemia not having achieved remission

C88.00, waldenstrom macroglobulinemia not having achieved remission, is listed as a covered diagnosis in 12 Medicare billing and coding articles that apply to 84 HCPCS Level II codes, including J9312 (Injection, rituximab, 10 mg), Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg), Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg). 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 C88.00 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J9312Injection, rituximab, 10 mgSpecial coverage instructions apply—3
Q5119Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mgCarrier judgment—3
Q5115Injection, rituximab-abbs, biosimilar, (truxima), 10 mgSpecial coverage instructions apply—3
Q5123Injection, rituximab-arrx, biosimilar, (riabni), 10 mgCarrier judgment—2
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—1
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—1
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—1
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—1
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—1
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iuSpecial coverage instructions apply—1
J1552Injection, immune globulin (alyglo), 500 mgCarrier judgment—1
J2792Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iuSpecial coverage instructions apply—1
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

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

Medicare policy articles listing C88.00

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 C88 diagnoses (Malignant immunoproliferative diseases and certain other B-cell lymphomas)

Frequently asked questions

Does Medicare cover C88.00 (Waldenstrom macroglobulinemia not having achieved remission)?

Medicare covers items and services, not diagnoses. 12 Medicare billing and coding articles list C88.00 as a covered diagnosis for 84 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 C88.00?

The Level II codes from the policies most specific to this diagnosis are J9312 (Injection, rituximab, 10 mg, 3 articles); Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg, 3 articles); Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg, 3 articles); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 2 articles); J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C88.00?

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 C88.00?

A58582 (Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars); A56718 (Billing and Coding: Intravenous Immunoglobulin (IVIG)); A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization), and 9 more articles.

What is ICD-10-CM code C88.00?

C88.00 is the ICD-10-CM code for waldenstrom macroglobulinemia not having achieved remission, in category C88 (Malignant immunoproliferative diseases and certain other B-cell lymphomas), 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