C91.00: Acute lymphoblastic leukemia not having achieved remission

C91.00, acute lymphoblastic leukemia not having achieved remission, is listed as a covered diagnosis in 13 Medicare billing and coding articles that apply to 130 HCPCS Level II codes, including J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use)), J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units), Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…). 25 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 C91.00 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)Special coverage instructions apply—3
J0885Injection, epoetin alfa, (for non-esrd use), 1000 unitsSpecial coverage instructions apply—3
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsSpecial coverage instructions apply—3
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)Special coverage instructions apply—3
Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 unitsSpecial coverage instructions apply—3
J0890Injection, peginesatide, 0.1 mg (for esrd on dialysis)Carrier judgment—3
Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)Special coverage instructions apply—3
J9312Injection, rituximab, 10 mgSpecial coverage instructions apply—2
Q5123Injection, rituximab-arrx, biosimilar, (riabni), 10 mgCarrier judgment—2
Q5119Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mgCarrier judgment—2
Q5115Injection, rituximab-abbs, biosimilar, (truxima), 10 mgSpecial coverage instructions apply—2
E0783Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)Special coverage instructions apply$9,917.33–$11,667.45 (NU)2
E0786Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)Special coverage instructions apply$10,969.75–$11,380.88 (NU)2
E0782Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)Special coverage instructions apply$5,200.92–$6,118.73 (NU)2
E0785Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacementSpecial coverage instructions apply$572.38–$673.39 (KF)2
J7999Compounded drug, not otherwise classifiedSpecial coverage instructions apply—2
J2274Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mgSpecial coverage instructions apply—2
J0888Injection, epoetin beta, 1 microgram, (for non esrd use)Special coverage instructions apply—2
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)Special coverage instructions apply—2
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
E0784External ambulatory infusion pump, insulinSpecial coverage instructions apply$557.75–$635.90 (RR)1
K0455Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)Special coverage instructions apply$320.84–$483.38 (RR)1
E0791Parenteral infusion pump, stationary, single or multi-channelSpecial coverage instructions apply$282.07–$427.07 (RR)1
E0781Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patientSpecial coverage instructions apply$309.33–$396.36 (RR)1

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

Medicare policy articles listing C91.00

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 C91 diagnoses (Lymphoid leukemia)

Frequently asked questions

Does Medicare cover C91.00 (Acute lymphoblastic leukemia not having achieved remission)?

Medicare covers items and services, not diagnoses. 13 Medicare billing and coding articles list C91.00 as a covered diagnosis for 130 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 C91.00?

The Level II codes from the policies most specific to this diagnosis are J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 3 articles); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 3 articles); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 3 articles); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 3 articles); Q5105 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 3 articles). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C91.00?

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 C91.00?

A52507 (External Infusion Pumps - Policy Article); A56380 (Billing and Coding: Rituximab); A59101 (Billing and Coding: Off-label Use of Rituximab and Rituximab Biosimilars), and 10 more articles.

What is ICD-10-CM code C91.00?

C91.00 is the ICD-10-CM code for acute lymphoblastic leukemia not having achieved remission, in category C91 (Lymphoid leukemia), 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