Cardiology Coding Alert

Bradycardia is a type of arrhythmia, which is defined as an abnormal rate or rhythm of the heartbeat. The heart 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.

“Bradycardia can occur for a variety of reasons, and not all require treatment, especially if the patient is asymptomatic,” Hodge adds. “It can be caused by medical conditions such as heart disease or hypothyroidism, among others, or it can be caused by medication side effects.”

Code R00.1 Covers Myriad of Conditions

FAQ 2: Which ICD-10-CM code should I report for sinus bradycardia?

Answer: Report R00.1 (Bradycardia, unspecified) for sinus bradycardia, which is a type of bradycardia that originates from the sinus node of the heart. This condition is most common in patients who exercise regularly or who are older than 65.

The alphabetical index of ICD-10 CM for bradycardia directs you to R00.1, Hodge explains. In the numeric index, under R00.1, you will find sinus bradycardia.

Don’t miss: Code R00.1 also includes sinoatrial bradycardia, slow heartbeat, and vagal bradycardia.

Coding tip: Use an additional code for adverse effect, if applicable, to identify drugs T36- (Poisoning by, adverse effect of and underdosing of systemic antibiotics) through T50- (Poisoning by, adverse effect of and underdosing of diuretics and other and unspecified drugs, medicaments and biological substances), per ICD-10-CM.

Figure Out How to Code Sick Sinus Syndrome

FAQ 3: If my cardiologist documents sick sinus syndrome, which ICD-10-CM code should I report on my claim?

Answer: Report I49.5 (Sick sinus syndrome) for sick sinus syndrome, says Catherine Brink, BS, CPC, CMM, president of Healthcare Resource Management in Spring Lake, New Jersey.

If you look in the ICD-10-CM book, you will see that code I49.5 also includes tachycardia-bradycardia syndrome, which occurs when the patient’s heart sometimes beats too quickly (tachycardia) and sometimes beats too slowly (bradycardia). Patients with tachycardia-bradycardia syndrome may have palpitations and lightheadedness. They may also pass out and be at a higher risk of stroke.

Don’t miss: Sick sinus syndrome (SSS) is a type of bradycardia (slow heart rate) where the sinoatrial node (aka sinus node) isn’t working properly. The electrical signals are abnormally paced, and the patient’s heartbeat can be too fast, too slow, interrupted by long pauses, or a combination of different rhythms.

Heed This Bradycardia Reporting Advice

FAQ 4: I am new to cardiology coding. Do you have any helpful tips I can follow when reporting for bradycardia?

Answer: Coders need to be careful when coding bradycardia and cross-check all diagnosis codes that the provider may have documented in addition to bradycardia, Hodge explains.

Also, if the bradycardia is caused by a medication, an additional code needs to be added to identify the adverse effect and to identify the drug, she says.

Physicians Use This Test to Diagnose Bradycardia

FAQ 5: How can physicians use to diagnose bradycardia?

Answer: Physicians can use a test called an electrocardiogram (ECG) to diagnose bradycardia.

An ECG is the recording of electrical activities of the heart and their interpretation by a physician.

In the heart, the Sinoatrial (SA) Node, located in the right atrium, sends electrical impulses to the heart’s muscles, which contract, resulting in systole. For example, if the cardiologist performs a twelve-lead ECG, they use 12 electrodes placed on the skin over different regions of the patient’s body (the limbs and chest). These electrodes then record the heart’s electrical activities, and the recordings are put into a graphic format.