Sick Sinus Syndrome
By Cathie Wilde, RHIA, CCS – Director of Coding Services, Medical Record Associates, LLC

Here are some common coding situations which have Coding Clinic references but for which are often missed:


If a patient has a pacemaker in place for sick sinus syndrome (SSS), should the SSS (I49.5) be coded because it is being treated with the pacemaker?

If there is no treatment or attention to the condition itself or the device per the criteria outlined in the ICD-10-CM Official Guidelines for Coding and Reporting, Section III. Reporting Additional Diagnoses, then code to presence of cardiac pacemaker (Z95.0) only. (Coding Clinic Fifth Issue 1993, page 12)


When a patient has sick sinus syndrome (SSS) that is controlled with a pacemaker and during an encounter, the pacemaker is interrogated – how is this coded?

Code to encounter for adjustment and management of cardiac pacemaker (Z45.01). (Coding Clinic 3Q 2010, p. 9-10)