C96.9: Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified

C96.9, malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 65 HCPCS Level II codes, including J9312 (Injection, rituximab, 10 mg), Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg), Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 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 C96.9 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
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
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
J9311Injection, rituximab 10 mg and hyaluronidaseSpecial coverage instructions apply—1
J3590Unclassified biologicsCarrier judgment—1
J9267Injection, paclitaxel, 1 mgSpecial coverage instructions apply—1
J9264Injection, paclitaxel protein-bound particles, 1 mgCarrier judgment—1
G0340Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatmentCarrier judgment—1
G0339Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatmentCarrier judgment—1
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—1
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—1
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—1
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—1
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—1
J8999Prescription drug, oral, chemotherapeutic, nosSpecial coverage instructions apply—1
J8530Cyclophosphamide; oral, 25 mgSpecial coverage instructions apply—1
J8597Antiemetic drug, oral, not otherwise specifiedSpecial coverage instructions apply—1
J8610Methotrexate; oral, 2.5 mgSpecial coverage instructions apply—1
J8498Antiemetic drug, rectal/suppository, not otherwise specifiedSpecial coverage instructions apply—1
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)Special coverage instructions apply—1
J0885Injection, epoetin alfa, (for non-esrd use), 1000 unitsSpecial coverage instructions apply—1
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsSpecial coverage instructions apply—1

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

Medicare policy articles listing C96.9

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 C96 diagnoses (Other and unspecified malignant neoplasms of lymphoid, hematopoietic and related tissue)

Frequently asked questions

Does Medicare cover C96.9 (Malignant neoplasm of lymphoid, hematopoietic and related…)?

Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list C96.9 as a covered diagnosis for 65 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 C96.9?

The Level II codes from the policies most specific to this diagnosis are J9312 (Injection, rituximab, 10 mg, 2 articles); Q5123 (Injection, rituximab-arrx, biosimilar, (riabni), 10 mg, 2 articles); Q5119 (Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg, 2 articles); Q5115 (Injection, rituximab-abbs, biosimilar, (truxima), 10 mg, 2 articles); Q0512 (Pharmacy supply fee for oral anti-cancer, oral anti-emetic…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with C96.9?

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 C96.9?

A56380 (Billing and Coding: Rituximab); A52450 (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)); A59350 (Billing and Coding: Radiation Therapies), and 7 more articles.

What is ICD-10-CM code C96.9?

C96.9 is the ICD-10-CM code for malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified, in category C96 (Other and unspecified malignant neoplasms of lymphoid, hematopoietic and related tissue), 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