C94.00: Acute erythroid leukemia, not having achieved remission
C94.00, acute erythroid leukemia, not having achieved remission, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 44 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 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 C94.00 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 1 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 1 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 1 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 1 |
| J1245 | Injection, dipyridamole, per 10 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 | — | 1 |
| 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 | — | 1 |
| Q0162 | Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| J8540 | Dexamethasone, oral, 0.25 mg | Special coverage instructions apply | — | 1 |
| Q0166 | Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen | Special coverage instructions apply | — | 1 |
| J8501 | Aprepitant, oral, 5 mg | Special coverage instructions apply | — | 1 |
| Q0164 | Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0163 | Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| J8655 | Netupitant 300 mg and palonosetron 0.5 mg, oral | Special coverage instructions apply | — | 1 |
| J8670 | Rolapitant, oral, 1 mg | Special coverage instructions apply | — | 1 |
| Q0155 | Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0161 | Chlorpromazine hydrochloride, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Carrier judgment | — | 1 |
| Q0167 | Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0169 | Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0173 | Trimethobenzamide hydrochloride, 250 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0175 | Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0177 | Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0180 | Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen | Special coverage instructions apply | — | 1 |
| Q0181 | Unspecified oral dosage form, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for a iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | Special coverage instructions apply | — | 1 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $9,917.33–$11,667.45 (NU) | 1 |
19 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C94.00
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes)
- 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
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- 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 C94 diagnoses (Other leukemias of specified cell type)
- C94.01 — Acute erythroid leukemia, in remission
- C94.02 — Acute erythroid leukemia, in relapse
- C94.20 — Acute megakaryoblastic leukemia not having achieved remission
- C94.21 — Acute megakaryoblastic leukemia, in remission
- C94.22 — Acute megakaryoblastic leukemia, in relapse
- C94.30 — Mast cell leukemia not having achieved remission
- C94.31 — Mast cell leukemia, in remission
- C94.32 — Mast cell leukemia, in relapse
- C94.40 — Acute panmyelosis with myelofibrosis not having achieved remission
- C94.41 — Acute panmyelosis with myelofibrosis, in remission
- C94.42 — Acute panmyelosis with myelofibrosis, in relapse
- C94.6 — Myelodysplastic disease, not elsewhere classified
- C94.80 — Other specified leukemias not having achieved remission
- C94.81 — Other specified leukemias, in remission
- C94.82 — Other specified leukemias, in relapse
Frequently asked questions
Does Medicare cover C94.00 (Acute erythroid leukemia, not having achieved remission)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list C94.00 as a covered diagnosis for 44 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 C94.00?
The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 1 article); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 1 article); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 1 article); J0280 (Injection, aminophyllin, up to 250 mg, 1 article); J1245 (Injection, dipyridamole, per 10 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with C94.00?
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 C94.00?
A54768 (Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy); A52480 (Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article); A56695 (Billing and Coding: Implantable Infusion Pump), and 2 more articles.
What is ICD-10-CM code C94.00?
C94.00 is the ICD-10-CM code for acute erythroid leukemia, not having achieved remission, in category C94 (Other leukemias of specified cell type), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J0461
- Watch J0461 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0461
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.