ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I45.5

Billable / Specific

Other specified heart block

I45
Block
2
Synonyms
281
LCDs
20
Payer Policies
0
Linked CPTs

About ICD-10-CM I45.5

ICD-10-CM code I45.5 represents Other specified heart block. This is a billable/specific code in the Circulatory System chapter (block I45). The 2026 edition of ICD-10-CM I45.5 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I45.5. Per CMS ICD-10-CM Tabular 2026.

  • Sinoatrial block
  • Sinoauricular block

Type 1 Excludes

Pure excludes, these codes can never be coded together with I45.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • heart block NOS (I45.9)

Medicare LCD Coverage for I45.5

Local Coverage Determinations (LCDs) from CMS MACs that list I45.5 as a covered diagnosis.

281 LCDs

Showing top 10 of 281 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93270 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93298 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93225 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93271 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93246 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93272 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93242 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 93228 →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 0938T →
CMS LCD: Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring
Article ID: 59270, Effective: 2025-01-01 00:00:00, 153 covered, 0 non-covered
CPT 0937T →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I45.5.

20 policies

1 Aetna

Positron Emission Tomography (PET) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0071

1 Cigna

Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Billing and Coding: Infliximab and biosimilars
Policy ID: ART-52423
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers
Policy ID: ART-54926
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemaker
Policy ID: ART-54958
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers
Policy ID: ART-54982
Billing and Coding: Cardiac Event Detection
Policy ID: ART-56452

CPT Codes Commonly Billed with I45.5

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for I45.5

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert I45.5 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I45.5 4266 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I45.5, Billing FAQ

Is ICD-10 code I45.5 billable? +

Yes, I45.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to I45.5? +

ICD-10 I45.5 includes: Sinoatrial block; Sinoauricular block.

What codes are Type 1 Excludes for I45.5? +

Type 1 Excludes (never code together with I45.5): heart block NOS (I45.9)

What ICD-9 codes does I45.5 map to? +

Per CMS GEMs, I45.5 maps to ICD-9 codes: 4266. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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