D00.00: Carcinoma in situ of oral cavity, unspecified site
D00.00, carcinoma in situ of oral cavity, unspecified site, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 44 HCPCS Level II codes, including Q5110 (Injection, filgrastim-aafi, biosimilar, (nivestym), 1…), Q5125 (Injection, filgrastim-ayow, biosimilar, (releuko), 1…), Q5101 (Injection, filgrastim-sndz, biosimilar, (zarxio), 1…). 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 2 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 D00.00 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q5110 | Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram | Special coverage instructions apply | — | 1 |
| Q5125 | Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram | Carrier judgment | — | 1 |
| Q5101 | Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram | Special coverage instructions apply | — | 1 |
| J1442 | Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram | Special coverage instructions apply | — | 1 |
| J1449 | Injection, eflapegrastim-xnst, 0.1 mg | Carrier judgment | — | 1 |
| J1447 | Injection, tbo-filgrastim, 1 microgram | Special coverage instructions apply | — | 1 |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5127 | Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5130 | Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| J2820 | Injection, sargramostim (gm-csf), 50 mcg | Special coverage instructions apply | — | 1 |
| Q5120 | Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg | Carrier judgment | — | 1 |
| Q5148 | Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram | Special coverage instructions apply | — | 1 |
| Q5169 | Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg | Carrier judgment | — | 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 |
19 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing D00.00
- 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
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 D00 diagnoses (Carcinoma in situ of oral cavity, esophagus and stomach)
- D00.01 — Carcinoma in situ of labial mucosa and vermilion border
- D00.02 — Carcinoma in situ of buccal mucosa
- D00.03 — Carcinoma in situ of gingiva and edentulous alveolar ridge
- D00.04 — Carcinoma in situ of soft palate
- D00.05 — Carcinoma in situ of hard palate
- D00.06 — Carcinoma in situ of floor of mouth
- D00.07 — Carcinoma in situ of tongue
- D00.08 — Carcinoma in situ of pharynx
- D00.1 — Carcinoma in situ of esophagus
- D00.2 — Carcinoma in situ of stomach
Frequently asked questions
Does Medicare cover D00.00 (Carcinoma in situ of oral cavity, unspecified site)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list D00.00 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 D00.00?
The Level II codes from the policies most specific to this diagnosis are Q5110 (Injection, filgrastim-aafi, biosimilar, (nivestym), 1…, 1 article); Q5125 (Injection, filgrastim-ayow, biosimilar, (releuko), 1…, 1 article); Q5101 (Injection, filgrastim-sndz, biosimilar, (zarxio), 1…, 1 article); J1442 (Injection, filgrastim (g-csf), excludes biosimilars, 1…, 1 article); J1449 (Injection, eflapegrastim-xnst, 0.1 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with D00.00?
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 D00.00?
A56748 (Billing and Coding: White Cell Colony Stimulating Factors); A52480 (Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article); A56695 (Billing and Coding: Implantable Infusion Pump).
What is ICD-10-CM code D00.00?
D00.00 is the ICD-10-CM code for carcinoma in situ of oral cavity, unspecified site, in category D00 (Carcinoma in situ of oral cavity, esophagus and stomach), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under Q5110
- Watch Q5110 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q5110
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.