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2025 ICD-10-CM code I49.5

Sick sinus syndrome (SSS), including tachycardia-bradycardia syndrome, characterized by irregular heartbeats due to dysfunction of the sinus node.

Follow the official ICD-10-CM coding guidelines published by the Centers for Medicare & Medicaid Services (CMS).

Modifiers are not applicable to ICD-10-CM codes.

Medical necessity for the diagnosis and treatment of SSS is established based on the presence of clinically significant symptoms (syncope, near syncope, dizziness, palpitations, shortness of breath, fatigue) caused by the abnormal heart rhythm, posing a risk to the patient's health and well-being.

Diagnosis and management of the arrhythmia, including the need for a pacemaker or other interventions based on the severity of symptoms and the patient's clinical presentation.

IMPORTANT:R00.1 (Bradycardia, unspecified) may be used for sinus bradycardia without additional symptoms characteristic of SSS.However, if the patient exhibits symptoms indicative of SSS (tachycardia-bradycardia syndrome, for example), I49.5 is the more appropriate code.

In simple words: Sick sinus syndrome means your heart's natural pacemaker isn't working correctly. This can cause your heart to beat too fast, too slow, or skip beats, leading to symptoms like dizziness or fainting.Sometimes, it causes alternating periods of fast and slow heartbeats.

I49.5, Sick sinus syndrome, encompasses a range of heart rhythm disturbances stemming from the dysfunction of the sinoatrial (SA) node, the heart's natural pacemaker.This dysfunction can manifest as bradycardia (slow heart rate), tachycardia (fast heart rate), pauses in heartbeat, or a combination of these, leading to inadequate blood flow to the body.The condition may be asymptomatic or cause symptoms like dizziness, fainting, shortness of breath, and chest pain.Tachycardia-bradycardia syndrome, a specific manifestation of SSS, is also included under this code. This is characterized by alternating episodes of fast and slow heartbeats.

Example 1: A 70-year-old patient presents with episodes of dizziness and near-syncope.ECG reveals varying degrees of bradycardia and tachycardia.Diagnosis: Sick sinus syndrome with tachycardia-bradycardia syndrome.A pacemaker is implanted., A 65-year-old patient experiences periods of extreme fatigue and shortness of breath.ECG shows significant pauses in the heartbeat, characteristic of SSS.Medical management is initiated with medication., A 55-year-old patient reports palpitations and lightheadedness.Electrophysiological study confirms SSS.The patient undergoes cardiac ablation to address the arrhythmia.

Detailed history of symptoms, physical examination findings, ECG results (showing bradycardia, tachycardia, pauses, or the combination of these), and any results of electrophysiological studies (EPS).

** When coding SSS, it's crucial to differentiate it from other bradycardia types.The presence of associated symptoms and the results of diagnostic tests are vital for accurate coding.

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