Sick Sinus Syndrome (SSS) is a condition in which the patient’s heart rhythm is disrupted; depending on the patient’s symptoms, he or she may receive a permanent pacemaker (PPM) to regulate the heart’s rhythm. In the past, SSS (I49.5) was coded until the patient received the PPM, and subsequent visits only included the PPM code (Z95.0).

However, guidelines have changed and despite the patient’s PPM, SSS is considered to still be present and reportable as a chronic condition as long as both diagnoses are properly assessed and documented in the progress note.

From a risk adjusted payment standpoint, this is good news as SSS is a risk adjusted code and PPM is not.