C88.31: Immunoproliferative small intestinal disease, in remission

C88.31, immunoproliferative small intestinal disease, in remission, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 72 HCPCS Level II codes, including J1569 (Injection, immune globulin, (gammagard liquid/gammagard…), J1561 (Injection, immune globulin, (gamunex-c/gammaked)…), J1459 (Injection, immune globulin (privigen), intravenous…). 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 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 C88.31 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—2
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—2
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—2
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—2
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—2
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—2
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—2
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—2
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—2
J1577Injection, immune globulin (qivigy), 100 mgCarrier judgment—2
J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial 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—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
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulinCarrier judgment—1
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1460Injection, gamma globulin, intramuscular, 1 ccSpecial coverage instructions apply—1
J1670Injection, tetanus immune globulin, human, up to 250 unitsSpecial coverage instructions apply—1
J0840Injection, crotalidae polyvalent immune fab (ovine), up to 1 gramCarrier judgment—1
J0850Injection, cytomegalovirus immune globulin intravenous (human), per vialSpecial coverage instructions apply—1
J1552Injection, immune globulin (alyglo), 500 mgCarrier judgment—1
J1560Injection, gamma globulin, intramuscular, over 10 ccSpecial coverage instructions apply—1
J1571Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 mlSpecial coverage instructions apply—1
J1573Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 mlCarrier judgment—1
J8999Prescription drug, oral, chemotherapeutic, nosSpecial coverage instructions apply—1

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

Medicare policy articles listing C88.31

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 C88.31 (Immunoproliferative small intestinal disease, in remission)?

Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list C88.31 as a covered diagnosis for 72 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 C88.31?

The Level II codes from the policies most specific to this diagnosis are J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 2 articles); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 2 articles); J1459 (Injection, immune globulin (privigen), intravenous…, 2 articles); J1557 (Injection, immune globulin, (gammaplex), intravenous…, 2 articles); J1556 (Injection, immune globulin (bivigam), 500 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C88.31?

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 C88.31?

A59105 (Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)); A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A57554 (Billing and Coding: Immune Globulins), and 4 more articles.

What is ICD-10-CM code C88.31?

C88.31 is the ICD-10-CM code for immunoproliferative small intestinal disease, in 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