D09.21: Carcinoma in situ of right eye
D09.21, carcinoma in situ of right eye, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 58 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…). 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 D09.21 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0881 | Injection, darbepoetin alfa, 1 microgram (non-esrd use) | Special coverage instructions apply | — | 2 |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | Special coverage instructions apply | — | 2 |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units | Special coverage instructions apply | — | 2 |
| J0882 | Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| J0888 | Injection, epoetin beta, 1 microgram, (for non esrd use) | Special coverage instructions apply | — | 2 |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units | Special coverage instructions apply | — | 2 |
| J0887 | Injection, epoetin beta, 1 microgram, (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| J0890 | Injection, peginesatide, 0.1 mg (for esrd on dialysis) | Carrier judgment | — | 2 |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | Special coverage instructions apply | — | 2 |
| 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 |
| 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 |
33 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing D09.21
- A58982: Billing and Coding: Erythropoiesis Stimulating Agents (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- 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)
- 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
- A60381: Billing and Coding: Erythropoiesis Stimulating Agents (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L39237
- 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 D09 diagnoses (Carcinoma in situ of other and unspecified sites)
- D09.22 — Carcinoma in situ of left eye
- D09.0 — Carcinoma in situ of bladder
- D09.19 — Carcinoma in situ of other urinary organs
- D09.3 — Carcinoma in situ of thyroid and other endocrine glands
- D09.8 — Carcinoma in situ of other specified sites
Frequently asked questions
Does Medicare cover D09.21 (Carcinoma in situ of right eye)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list D09.21 as a covered diagnosis for 58 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 D09.21?
The Level II codes from the policies most specific to this diagnosis are J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use), 2 articles); J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units, 2 articles); Q5106 (Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for…, 2 articles); J0882 (Injection, darbepoetin alfa, 1 microgram (for esrd on…, 2 articles); J0888 (Injection, epoetin beta, 1 microgram, (for non esrd use), 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with D09.21?
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 D09.21?
A58982 (Billing and Coding: Erythropoiesis Stimulating Agents); A54768 (Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy); A56748 (Billing and Coding: White Cell Colony Stimulating Factors), and 3 more articles.
What is ICD-10-CM code D09.21?
D09.21 is the ICD-10-CM code for carcinoma in situ of right eye, in category D09 (Carcinoma in situ of other and unspecified sites), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J0881
- Watch J0881 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0881
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.