C88.81: Other malignant immunoproliferative diseases, in remission
C88.81, other malignant immunoproliferative diseases, in remission, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 81 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 C88.81 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J1569 | Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg | Special coverage instructions apply | — | 2 |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 2 |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 2 |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 2 |
| J1556 | Injection, immune globulin (bivigam), 500 mg | Carrier judgment | — | 2 |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 2 |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | Special coverage instructions apply | — | 2 |
| J1554 | Injection, immune globulin (asceniv), 500 mg | Carrier judgment | — | 2 |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | Carrier judgment | — | 2 |
| J1577 | Injection, immune globulin (qivigy), 100 mg | Carrier judgment | — | 2 |
| J1576 | Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 1 |
| J1575 | Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin | Carrier judgment | — | 1 |
| J1572 | Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1460 | Injection, gamma globulin, intramuscular, 1 cc | Special coverage instructions apply | — | 1 |
| J1670 | Injection, tetanus immune globulin, human, up to 250 units | Special coverage instructions apply | — | 1 |
| J0840 | Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram | Carrier judgment | — | 1 |
| J0850 | Injection, cytomegalovirus immune globulin intravenous (human), per vial | Special coverage instructions apply | — | 1 |
| J1552 | Injection, immune globulin (alyglo), 500 mg | Carrier judgment | — | 1 |
| J1560 | Injection, gamma globulin, intramuscular, over 10 cc | Special coverage instructions apply | — | 1 |
| J1571 | Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml | Special coverage instructions apply | — | 1 |
| J1573 | Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml | Carrier judgment | — | 1 |
| J8999 | Prescription drug, oral, chemotherapeutic, nos | Special coverage instructions apply | — | 1 |
56 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C88.81
- A59105: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG) (Wellpoint Federal (MAC - Part A, MAC - Part B); 11 Level II codes). LCD with the same title: L39314
- A56389: Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34434
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 20 Level II codes). LCD with the same title: L34771
- A52479: Oral Anticancer Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 8 Level II codes). LCD with the same title: L33826
- A56748: Billing and Coding: White Cell Colony Stimulating Factors (Palmetto GBA (MAC - Part A, MAC - Part B); 16 Level II codes). LCD with the same title: L37176
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
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)
- C88.80 — Other malignant immunoproliferative diseases not having achieved…
- C88.00 — Waldenstrom macroglobulinemia not having achieved remission
- C88.01 — Waldenstrom macroglobulinemia, in remission
- C88.20 — Heavy chain disease not having achieved remission
- C88.21 — Heavy chain disease, in remission
- C88.30 — Immunoproliferative small intestinal disease not having achieved…
- C88.31 — Immunoproliferative small intestinal disease, in remission
- C88.40 — Extranodal marginal zone B-cell lymphoma of mucosa-associated…
- C88.41 — Extranodal marginal zone B-cell lymphoma of mucosa-associated…
- C88.90 — Malignant immunoproliferative disease, unspecified not having…
- C88.91 — Malignant immunoproliferative disease, unspecified, in remission
Frequently asked questions
Does Medicare cover C88.81 (Other malignant immunoproliferative diseases, in remission)?
Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list C88.81 as a covered diagnosis for 81 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 C88.81?
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 C88.81?
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 C88.81?
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 5 more articles.
What is ICD-10-CM code C88.81?
C88.81 is the ICD-10-CM code for other malignant immunoproliferative diseases, in remission, in category C88 (Malignant immunoproliferative diseases and certain other B-cell lymphomas), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J1569
- Watch J1569 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1569
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.