Q85.01: Neurofibromatosis, type 1

Q85.01, neurofibromatosis, type 1, is listed as a covered diagnosis in 16 Medicare billing and coding articles that apply to 68 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 6 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 Q85.01 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
G0453Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)Carrier judgment—2
C8900Magnetic resonance angiography with contrast, abdomenSpecial coverage instructions apply—2
C8901Magnetic resonance angiography without contrast, abdomenSpecial coverage instructions apply—2
C8902Magnetic resonance angiography without contrast followed by with contrast, abdomenSpecial coverage instructions apply—2
C8909Magnetic resonance angiography with contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8910Magnetic resonance angiography without contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8911Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8912Magnetic resonance angiography with contrast, lower extremitySpecial coverage instructions apply—2
C8913Magnetic resonance angiography without contrast, lower extremitySpecial coverage instructions apply—2
C8914Magnetic resonance angiography without contrast followed by with contrast, lower extremitySpecial coverage instructions apply—2
C8918Magnetic resonance angiography with contrast, pelvisSpecial coverage instructions apply—2
C8919Magnetic resonance angiography without contrast, pelvisSpecial coverage instructions apply—2
C8920Magnetic resonance angiography without contrast followed by with contrast, pelvisSpecial 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
C8931Magnetic resonance angiography with contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8932Magnetic resonance angiography without contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8933Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contentsSpecial coverage instructions apply—1

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

Medicare policy articles listing Q85.01

1 more articles list Q85.01.

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 Q85 diagnoses (Phakomatoses, not elsewhere classified)

Frequently asked questions

Does Medicare cover Q85.01 (Neurofibromatosis, type 1)?

Medicare covers items and services, not diagnoses. 16 Medicare billing and coding articles list Q85.01 as a covered diagnosis for 68 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 Q85.01?

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 Q85.01?

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 Q85.01?

A57604 (Billing and Coding: Intraoperative Neurophysiological Testing); A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A56805 (Billing and Coding: Magnetic Resonance Angiography (MRA)), and 13 more articles.

What is ICD-10-CM code Q85.01?

Q85.01 is the ICD-10-CM code for neurofibromatosis, type 1, in category Q85 (Phakomatoses, not elsewhere classified), chapter 17: Congenital malformations and chromosomal abnormalities.

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 17: Congenital malformations and chromosomal abnormalities · All diagnoses · HCPCS lookup