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

ICD-10 I49.5

Billable / Specific HCC v28: 96

Sick sinus syndrome

I49
Block
1
Synonyms
373
LCDs
29
Payer Policies
16
Linked CPTs

About ICD-10-CM I49.5

ICD-10-CM code I49.5 represents Sick sinus syndrome. This is a billable/specific code in the Circulatory System chapter (block I49). The 2026 edition of ICD-10-CM I49.5 became effective on October 1, 2025.

Coding Tips for I49.5

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I49.5 is a CMS-HCC v28 risk-adjustment code (category 96). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I49.5. Per CMS ICD-10-CM Tabular 2026.

  • Tachycardia-bradycardia syndrome

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 96
ESRD-HCC
Category 96
RxHCC (Part D)
Category 96

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for I49.5

Local Coverage Determinations (LCDs) from CMS MACs that list I49.5 as a covered diagnosis.

373 LCDs

Showing top 10 of 373 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 I49.5.

29 policies

1 Aetna

Apnea Monitors for Infants - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0003

1 Cigna

Ambulatory External and Implantable Electrocardiographic Monitoring - (0547)
Policy ID: MM_0547

5 Medicare

Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemaker
Policy ID: ART-54831
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers
Policy ID: ART-54909
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 Pacemakers � Coding and Billing
Policy ID: ART-54929
Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemaker
Policy ID: ART-54958

CPT Codes Commonly Billed with I49.5

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

16 linkages
  • 33208 CMS LCD: Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers � Coding and Billing CMS LCD
  • 33206 CMS LCD: Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers � Coding and Billing CMS LCD
  • 33207 CMS LCD: Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers � Coding and Billing CMS LCD
  • 0573T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
  • 0574T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
  • 0614T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
  • 0577T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
  • 0572T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
  • 0576T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD
  • 0575T CMS LCD: Billing and Coding: Implantable Automatic Defibrillators CMS LCD

Convert I49.5 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I49.5 42781 10000

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

ICD-10 I49.5, Billing FAQ

Is ICD-10 code I49.5 billable? +

Yes, I49.5 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 I49.5? +

ICD-10 I49.5 includes: Tachycardia-bradycardia syndrome.

Does I49.5 affect Medicare Advantage HCC risk adjustment? +

Yes. I49.5 maps to CMS-HCC v28 category 96. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with I49.5? +

Procedures frequently paired with I49.5 include: 33208, 33206, 33207, 0573T, 0574T.

What ICD-9 codes does I49.5 map to? +

Per CMS GEMs, I49.5 maps to ICD-9 codes: 42781. 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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