What is ICD-10 code I77.4?

I77.4 is the ICD-10-CM diagnosis code for Celiac artery compression syndrome. A condition where the celiac artery (which supplies the stomach and upper abdominal organs) is compressed, usually by a ligament, restricting blood flow and causing abdominal pain. I77.4 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I77.4 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I77.4 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I77.4 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for I77.4?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. I77.4 was a payment HCC under V24 (Vascular Disease) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting I77.4?

Document whether the condition is symptomatic or asymptomatic Often requires imaging confirmation such as CT or angiography Because I77.4 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM I77.4: Celiac artery compression

ICD-10-CM Code View

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Code lookupI77.4Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Diseases of arteries, arterioles and capillaries (I70-I79)

I77.4

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Celiac artery compression syndrome

A condition where the celiac artery (which supplies the stomach and upper abdominal organs) is compressed, usually by a ligament, restricting blood flow and causing abdominal pain.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 108

Vascular Disease

RAF 0.288

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 108

Vascular Disease

RAF 0.073

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I77Other disorders of arteries and arterioles

I77.4Celiac artery compression syndrome

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I77.4 in this effective period.

Excludes 2

Official

collagen (vascular) diseases (M30-M36)
hypersensitivity angiitis (M31.0)
pulmonary artery (I28.-)

Related Child Codes

Official

I77.0Arteriovenous fistula, acquired

I77.1Stricture of artery

I77.2Rupture of artery

I77.3Arterial fibromuscular dysplasia

I77.5Necrosis of artery

Includes

Official

ICD-10-CM does not list Includes notes for I77.4 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I77.4 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I77.4 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I77.4 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I77.4 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Specific documentation of celiac artery compression or median arcuate ligament syndrome

Imaging confirmation (CT angiography, mesenteric duplex ultrasound, or conventional angiography) showing compression

Symptomatic status including postprandial abdominal pain, nausea, or weight loss

Current treatment plan including dietary modifications, surgical referral, or ongoing monitoring

MEAT Support

HCC Buddy guidance

Specific documentation of celiac artery compression or median arcuate ligament syndrome

Imaging confirmation (CT angiography, mesenteric duplex ultrasound, or conventional angiography) showing compression

Symptomatic status including postprandial abdominal pain, nausea, or weight loss

Current treatment plan including dietary modifications, surgical referral, or ongoing monitoring

Audit Caution

HCC Buddy guidance

Coding this condition without imaging confirmation of celiac artery compression

Confusing with mesenteric ischemia (K55.x) which involves different pathophysiology

Failing to document whether the condition is symptomatic, which affects clinical management

Using unspecified vascular codes (I77.9) when the specific celiac compression diagnosis is documented

Common Mistakes

HCC Buddy guidance

I77.1 — Stricture of artery: use for intrinsic narrowing rather than external compression

K55.1 — Chronic vascular disorders of intestine: use when ischemia is established rather than compression syndrome

I77.89 — Other specified disorders of arteries and arterioles: less specific; use I77.4 when celiac compression is confirmed

I71.4 — Abdominal aortic aneurysm without rupture: involves aortic dilation, not compression

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is I77.4 an HCC code?

Yes. I77.4 maps to Vascular Disease under the V24 model but is not retained in V28.

Code: I77.4
Description: Celiac artery compression syndrome
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 108, Vascular Disease

0.288

ESRDHCC 108, Vascular Disease

0.073

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work I77.4 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I77.4

For I77.4 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I77.4 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I77.4 is the ICD-10-CM diagnosis code for celiac artery compression syndrome. A condition where the celiac artery (which supplies the stomach and upper abdominal organs) is compressed, usually by a ligament, restricting blood flow and causing abdominal pain. I77.4 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering diseases of arteries, arterioles and capillaries (i70-i79).

Under the older CMS-HCC V24 model, I77.4 maps to Vascular Disease (HCC 108) with a community, non-dual, aged base RAF weight of 0.288. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Document whether the condition is symptomatic or asymptomatic. Because I77.4 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I77.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document whether the condition is symptomatic or asymptomatic
•Often requires imaging confirmation such as CT or angiography

Clinical Significance

Celiac artery compression syndrome (median arcuate ligament syndrome) represents a significant vascular condition where external compression restricts blood flow to upper abdominal organs, leading to chronic postprandial pain and potential malnutrition. For risk adjustment, this condition reflects ongoing vascular disease burden requiring monitoring and possible surgical intervention. It contributes to the patient's overall complexity and resource utilization.

Documentation Requirements

✓Specific documentation of celiac artery compression or median arcuate ligament syndrome
✓Imaging confirmation (CT angiography, mesenteric duplex ultrasound, or conventional angiography) showing compression
✓Symptomatic status including postprandial abdominal pain, nausea, or weight loss
✓Current treatment plan including dietary modifications, surgical referral, or ongoing monitoring
✓Provider assessment and clinical evaluation during the encounter

Commonly Confused Codes

•I77.1: Stricture of artery: use for intrinsic narrowing rather than external compression
•K55.1: Chronic vascular disorders of intestine: use when ischemia is established rather than compression syndrome
•I77.89: Other specified disorders of arteries and arterioles: less specific; use I77.4 when celiac compression is confirmed
•I71.4: Abdominal aortic aneurysm without rupture: involves aortic dilation, not compression