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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.72

R29.72

NIHSS score 20-29

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R29.72 is a billable code used to indicate a diagnosis of nihss score 20-29.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score ranging from 20 to 29 indicates a severe level of neurological impairment due to a stroke. Patients scoring within this range typically exhibit significant deficits in consciousness, language, motor function, and sensory perception. Common symptoms include profound weakness or paralysis on one side of the body, difficulty in speaking or understanding language, and impaired coordination. These patients may also present with altered mental status, including confusion or decreased responsiveness. The NIHSS is a critical tool used in the assessment of stroke severity and helps guide treatment decisions and prognostic evaluations. A score in this range suggests a high risk for complications and a need for intensive monitoring and rehabilitation. Accurate documentation of the NIHSS score is essential for coding and billing purposes, as it reflects the severity of the patient's condition and the complexity of care required.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in NIHSS scoring interpretation among clinicians
  • Need for precise documentation of neurological deficits
  • Potential overlap with other neurological conditions
  • Importance of timely and accurate assessment in acute settings

Audit Risk Factors

  • Inadequate documentation of NIHSS assessments
  • Failure to capture all relevant neurological deficits
  • Misinterpretation of NIHSS scores leading to incorrect coding
  • Lack of clarity in the clinical narrative regarding patient status

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Comprehensive documentation of neurological assessments, including NIHSS scores and detailed descriptions of deficits.

Common Clinical Scenarios

Patients presenting with acute ischemic stroke or hemorrhagic stroke requiring hospitalization.

Billing Considerations

Ensure that all neurological assessments are documented in a timely manner to support coding and billing.

Emergency Medicine

Documentation Requirements

Immediate and accurate documentation of NIHSS scores upon patient presentation and throughout the emergency care process.

Common Clinical Scenarios

Patients arriving at the emergency department with stroke symptoms requiring rapid assessment and intervention.

Billing Considerations

Document any changes in neurological status during the emergency visit to support coding for severity.

Coding Guidelines

Inclusion Criteria

Use R29.72 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and reflects the patient's clinical status
  • The score should be recorded in the medical record and linked to the appropriate clinical findings

Exclusion Criteria

Do NOT use R29.72 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient with an NIHSS score of 20-29 presents to the emergency department.

Documentation Requirements

Document the severity of the condition, including NIHSS score and clinical findings.

Specialty Considerations

Emergency medicine providers should ensure that all assessments are clearly documented to support the level of service billed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of stroke severity, improving the accuracy of clinical data and reimbursement processes. R29.72 provides a clear indication of the severity of neurological impairment, which is critical for treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity, improving the accuracy of clinical data and reimbursement processes. R29.72 provides a clear indication of the severity of neurological impairment, which is critical for treatment planning.

Reimbursement & Billing Impact

reimbursement processes. R29.72 provides a clear indication of the severity of neurological impairment, which is critical for treatment planning.

Resources

Clinical References

  • •
    NIHSS Training and Certification

Coding & Billing References

  • •
    NIHSS Training and Certification

Frequently Asked Questions

What does an NIHSS score of 20-29 indicate?

An NIHSS score of 20-29 indicates severe neurological impairment, suggesting significant deficits in motor function, language, and consciousness, requiring intensive medical intervention.