I77.76: Dissection of artery of upper extremity
I77.76, dissection of artery of upper extremity, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including G0278 (Iliac and/or femoral artery angiography, non-selective…), G0269 (Placement of occlusive device into either a venous or…), G2187 (Patients with clinical indications for imaging of the…). 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 I77.76 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| 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 | — | 2 |
| G0269 | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) | Special coverage instructions apply | — | 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 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior | Carrier judgment | — | 1 |
| G2195 | Patients with clinical indications for imaging of the head: occipital headache in children | Carrier judgment | — | 1 |
Medicare policy articles listing I77.76
- A52850: Billing and Coding: Cardiac Catheterization and Coronary Angiography (Wellpoint Federal (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- 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 I77 diagnoses (Other disorders of arteries and arterioles)
- I77.71 — Dissection of carotid artery
- I77.72 — Dissection of iliac artery
- I77.73 — Dissection of renal artery
- I77.74 — Dissection of vertebral artery
- I77.75 — Dissection of other precerebral arteries
- I77.77 — Dissection of artery of lower extremity
- I77.79 — Dissection of other specified artery
- I77.0 — Arteriovenous fistula, acquired
- I77.1 — Stricture of artery
- I77.2 — Rupture of artery
- I77.3 — Arterial fibromuscular dysplasia
- I77.4 — Celiac artery compression syndrome
- I77.5 — Necrosis of artery
- I77.6 — Arteritis, unspecified
- I77.810 — Thoracic aortic ectasia
- I77.811 — Abdominal aortic ectasia
- I77.812 — Thoracoabdominal aortic ectasia
- I77.82 — Antineutrophilic cytoplasmic antibody [ANCA] vasculitis
- I77.89 — Other specified disorders of arteries and arterioles
Frequently asked questions
Does Medicare cover I77.76 (Dissection of artery of upper extremity)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list I77.76 as a covered diagnosis for 11 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 I77.76?
The Level II codes from the policies most specific to this diagnosis are G0278 (Iliac and/or femoral artery angiography, non-selective…, 2 articles); G0269 (Placement of occlusive device into either a venous or…, 1 article); G2187 (Patients with clinical indications for imaging of the…, 1 article); G2188 (Patients with clinical indications for imaging of the…, 1 article); G2189 (Patients with clinical indications for imaging of the…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list I77.76?
A52850 (Billing and Coding: Cardiac Catheterization and Coronary Angiography); A57056 (Billing and Coding: Aortography and Peripheral Angiography); A56612 (Billing and Coding: CT of the Head).
What is ICD-10-CM code I77.76?
I77.76 is the ICD-10-CM code for dissection of artery of upper extremity, in category I77 (Other disorders of arteries and arterioles), chapter 9: Diseases of the circulatory system.
Next steps
- Run a reimbursement report for a device billed under G0278
- Watch G0278 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0278
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