Q85.03: Schwannomatosis

Q85.03, schwannomatosis, is listed as a covered diagnosis in 15 Medicare billing and coding articles that apply to 76 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), J0881 (Injection, darbepoetin alfa, 1 microgram (non-esrd use)), J0885 (Injection, epoetin alfa, (for non-esrd use), 1000 units). 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 Q85.03 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
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
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)Special coverage instructions apply—2
J0885Injection, epoetin alfa, (for non-esrd use), 1000 unitsSpecial coverage instructions apply—2
Q5106Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsSpecial coverage instructions apply—2
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)Special coverage instructions apply—2
J0888Injection, epoetin beta, 1 microgram, (for non esrd use)Special coverage instructions apply—2
Q5105Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 unitsSpecial coverage instructions apply—2
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)Special coverage instructions apply—2
J0890Injection, peginesatide, 0.1 mg (for esrd on dialysis)Carrier judgment—2
Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)Special coverage instructions apply—2
Q5129Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mgCarrier judgment—1
Q5126Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mgCarrier judgment—1
Q5118Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mgCarrier judgment—1
Q5107Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mgSpecial coverage instructions apply—1
J9035Injection, bevacizumab, 10 mgCarrier judgment—1
J3590Unclassified biologicsCarrier judgment—1
C9257Injection, bevacizumab, 0.25 mgSpecial coverage instructions apply—1
Q5160Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mgCarrier judgment—1
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—1
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—1
Q0162Ondansetron 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 regimenSpecial coverage instructions apply—1
J8540Dexamethasone, oral, 0.25 mgSpecial coverage instructions apply—1
Q0166Granisetron 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 regimenSpecial coverage instructions apply—1
J8501Aprepitant, oral, 5 mgSpecial coverage instructions apply—1
Q0164Prochlorperazine 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 regimenSpecial coverage instructions apply—1

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

Medicare policy articles listing Q85.03

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 Q85.03 (Schwannomatosis)?

Medicare covers items and services, not diagnoses. 15 Medicare billing and coding articles list Q85.03 as a covered diagnosis for 76 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 Q85.03?

The Level II codes from the policies most specific to this diagnosis are G0453 (Continuous intraoperative neurophysiology monitoring, from…, 2 articles); 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). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with Q85.03?

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 Q85.03?

A52370 (Billing and Coding: Bevacizumab and biosimilars); A57604 (Billing and Coding: Intraoperative Neurophysiological Testing); A56722 (Billing and Coding: Intraoperative Neurophysiological Testing), and 12 more articles.

What is ICD-10-CM code Q85.03?

Q85.03 is the ICD-10-CM code for schwannomatosis, 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