I25.42: Coronary artery dissection

I25.42, coronary artery dissection, is listed as a covered diagnosis in 11 Medicare billing and coding articles that apply to 42 HCPCS Level II codes, including C9600 (Percutaneous transcatheter placement of drug eluting…), C9601 (Percutaneous transcatheter placement of drug-eluting…), C9602 (Percutaneous transluminal coronary atherectomy, with drug…). The articles come from 4 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 I25.42 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
C9600Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branchSpecial coverage instructions apply—2
C9601Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)Special coverage instructions apply—2
C9602Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branchSpecial coverage instructions apply—2
C9603Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)Special coverage instructions apply—2
C9604Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vesselSpecial coverage instructions apply—2
C9605Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)Special coverage instructions apply—2
C9606Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vesselSpecial coverage instructions apply—2
C9607Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vesselSpecial coverage instructions apply—2
C9608Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)Special coverage instructions apply—2
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—4
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—4
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—4
A9500Technetium tc-99m sestamibi, diagnostic, per study doseCarrier judgment—2
A9502Technetium tc-99m tetrofosmin, diagnostic, per study doseCarrier judgment—2
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurieCarrier judgment—2
A9512Technetium tc-99m pertechnetate, diagnostic, per millicurieCarrier judgment—2
A9560Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuriesCarrier judgment—2
A9538Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuriesCarrier judgment—2
A9501Technetium tc-99m teboroxime, diagnostic, per study doseCarrier judgment—2
J2785Injection, regadenoson, 0.1 mgCarrier judgment—3
J3490Unclassified drugsSpecial coverage instructions apply—2
C8925Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—2
C8926Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—2
C8927Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basisSpecial coverage instructions apply—2
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—3

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

Medicare policy articles listing I25.42

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 I25 diagnoses (Chronic ischemic heart disease)

Frequently asked questions

Does Medicare cover I25.42 (Coronary artery dissection)?

Medicare covers items and services, not diagnoses. 11 Medicare billing and coding articles list I25.42 as a covered diagnosis for 42 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 I25.42?

The Level II codes from the policies most specific to this diagnosis are C9600 (Percutaneous transcatheter placement of drug eluting…, 2 articles); C9601 (Percutaneous transcatheter placement of drug-eluting…, 2 articles); C9602 (Percutaneous transluminal coronary atherectomy, with drug…, 2 articles); C9603 (Percutaneous transluminal coronary atherectomy, with…, 2 articles); C9604 (Percutaneous transluminal revascularization of or through…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list I25.42?

A57479 (Billing and Coding: Percutaneous Coronary Interventions); A56823 (Billing and Coding: Percutaneous Coronary Intervention); A56494 (Billing and Coding: Cardiovascular Nuclear Medicine), and 8 more articles.

What is ICD-10-CM code I25.42?

I25.42 is the ICD-10-CM code for coronary artery dissection, in category I25 (Chronic ischemic heart disease), chapter 9: Diseases of the circulatory system.

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 9: Diseases of the circulatory system · All diagnoses · HCPCS lookup