Cardiology Coding Alert

When your cardiologist sees a patient for bradycardia check the medical documentation to specify exactly what type of bradycardia the patient has because you will report different ICD-10-CM codes depending upon this information. You must also understand the relationship between arrythmias and bradycardia.

First, Define Bradycardia for Clarity

Question 1: What is bradycardia?

Answer 1: When a patient has bradycardia, their heart rate is too slow. Usually, an adult at rest will have a heartbeat of 60 to 100 times a minute. A patient with bradycardia will have a heartbeat of fewer than 60 times a minute.

Don’t miss: There can be certain exceptions to this, according to the American Heart Association (AHA). For example, a patient’s heart rate could fall below 60 beats per minute (BPM) when they are sleeping. Also, athletes could often have a resting heart rate slower than 60 BPM.

Decode What Arrhythmias Are

Question 2: Is bradycardia a type of arrythmia?

Answer 2: Yes. A bradycardia is a type of arrythmia.

An arrythmia is defined as an abnormal rate or rhythm of the heartbeat. It can beat too fast, too slow, or with an irregular rhythm. A heartbeat that is too fast is called tachycardia, and a heartbeat that is too slow is bradycardia.

“Cardiac arrhythmias can be tricky to code. For example, the provider may not always specify the patient has tachy-brady syndrome, but you will see documentation of the patient having tachycardia and bradycardia,” says Robin Peterson, CPC, CPMA, Manager of Professional Coding, Pinnacle Integrated Coding Solutions, LLC. “If you are in doubt always query your provider.”

Report This Code for Sinus Bradycardia

Question 3: What is sinus bradycardia and which ICD-10-CM code should I report for this condition?

Answer 3: Sinus bradycardia is a type of bradycardia that originates from the sinus node of the heart.

You should report R00.1 (Bradycardia, unspecified) for sinus bradycardia. Although the code description points to “unspecified bradycardia,” if you look in the ICD-10-CM manual, you will see that code R00.1 also includes the following conditions:

• Sinoatrial bradycardia
• Sinus bradycardia
• Slow heart beat
• Vagal bradycardia

Rely on I49.5 for Sick Sinus Syndrome

Question 4: What is sick sinus syndrome and what ICD-10-CM code should I report for this condition?

Answer 4: When a patient has sick sinus syndrome (SSS), their heart’s natural pacemaker, which is the sinus node, is not able to maintain a heart rate appropriate for their body’s needs. So, the patient will have arrythmias, such as bradycardia.

You should report I49.5 (Sick sinus syndrome) for sick sinus syndrome. With sick sinus syndrome, the electrical signals are abnormally paced. The patient’s heartbeat can be too fast, too slow, interrupted by long pauses, or a combination of different rhythms.

Don’t miss: Code I49.5 also includes tachycardia-bradycardia syndrome. This condition occurs when the patient’s heart will beat too quickly and too slowly.

Tips: If you choose I49.5, you should “code first” cardiac arrhythmia complicating:

• Abortion or ectopic or molar pregnancy (O00-O07, O08.8)
• Obstetric surgery and procedures (O75.4)

Pinpoint Bradycardia Symptoms

Question 5: What are some symptoms of bradycardia?

Answer 5: Symptoms of bradycardia include the following:

• Syncope
• Dizziness or lightheadedness
• Fatigue
• Shortness of breath
• Chest pain
• Confusion

Focus in on Bradycardia Treatment

Question 6: How will my cardiologist treat a patient’s bradycardia?

Answer 6: If a patient has severe or prolonged bradycardia, your cardiologist can insert a pacemaker to help regulate the patient’s heart rhythm.