I67.5: Moyamoya disease
I67.5, moyamoya disease, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 29 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), C8900 (Magnetic resonance angiography with contrast, abdomen), C8901 (Magnetic resonance angiography without contrast, abdomen). The articles come from 5 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 I67.5 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0453 | Continuous 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 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8931 | Magnetic resonance angiography with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8932 | Magnetic resonance angiography without contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8933 | Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8934 | Magnetic resonance angiography with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8935 | Magnetic resonance angiography without contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8936 | Magnetic resonance angiography without contrast followed by with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | Carrier judgment | — | 1 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
4 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing I67.5
- A57604: Billing and Coding: Intraoperative Neurophysiological Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A56722: Billing and Coding: Intraoperative Neurophysiological Testing (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A56747: Billing and Coding: Magnetic Resonance Angiography (MRA) (Wellpoint Federal (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L33633, L34372, L34865
- A57056: Billing and Coding: Aortography and Peripheral Angiography (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36767
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
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 I67 diagnoses (Other cerebrovascular diseases)
- I67.0 — Dissection of cerebral arteries, nonruptured
- I67.1 — Cerebral aneurysm, nonruptured
- I67.6 — Nonpyogenic thrombosis of intracranial venous system
- I67.81 — Acute cerebrovascular insufficiency
- I67.82 — Cerebral ischemia
- I67.841 — Reversible cerebrovascular vasoconstriction syndrome
- I67.848 — Other cerebrovascular vasospasm and vasoconstriction
- I67.850 — Cerebral autosomal dominant arteriopathy with subcortical infarcts…
- I67.858 — Other hereditary cerebrovascular disease
- I67.89 — Other cerebrovascular disease
Frequently asked questions
Does Medicare cover I67.5 (Moyamoya disease)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list I67.5 as a covered diagnosis for 29 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 I67.5?
The Level II codes from the policies most specific to this diagnosis are G0453 (Continuous intraoperative neurophysiology monitoring, from…, 2 articles); C8900 (Magnetic resonance angiography with contrast, abdomen, 1 article); C8901 (Magnetic resonance angiography without contrast, abdomen, 1 article); C8902 (Magnetic resonance angiography without contrast followed…, 1 article); C8909 (Magnetic resonance angiography with contrast, chest…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list I67.5?
A57604 (Billing and Coding: Intraoperative Neurophysiological Testing); A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A56747 (Billing and Coding: Magnetic Resonance Angiography (MRA)), and 2 more articles.
What is ICD-10-CM code I67.5?
I67.5 is the ICD-10-CM code for moyamoya disease, in category I67 (Other cerebrovascular diseases), chapter 9: Diseases of the circulatory system.
Next steps
- Run a reimbursement report for a device billed under G0453
- Watch G0453 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0453
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