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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.724

R29.724

NIHSS score 24

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

Code Description

ICD-10 R29.724 is a billable code used to indicate a diagnosis of nihss score 24.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 24 indicates a severe stroke, reflecting significant neurological impairment. This score is derived from a comprehensive assessment of various neurological functions, including consciousness, language, motor skills, sensory perception, and visual fields. A score of 24 suggests that the patient exhibits profound deficits, which may include severe aphasia, hemiplegia, and altered consciousness. The NIHSS is crucial for determining the severity of a stroke and guiding treatment decisions, including the need for thrombolysis or other interventions. Clinicians must document the specific deficits observed during the assessment to support the coding of this score accurately. The NIHSS score is widely used in both clinical and research settings to evaluate stroke outcomes and the effectiveness of therapeutic interventions.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires detailed clinical documentation of neurological deficits.
  • Involves understanding of stroke severity and its implications.
  • May be confused with other neurological assessment scales.
  • Documentation must clearly reflect the NIHSS scoring criteria.

Audit Risk Factors

  • Inadequate documentation of the NIHSS assessment.
  • Failure to specify the neurological deficits corresponding to the score.
  • Misalignment between the documented score and clinical findings.
  • Inconsistent use of the NIHSS in clinical notes.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Thorough documentation of neurological examination findings, including specific deficits and their impact on daily functioning.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms requiring NIHSS assessment for treatment decisions.

Billing Considerations

Ensure that all components of the NIHSS are documented to support the score and justify the medical necessity of interventions.

Emergency Medicine

Documentation Requirements

Immediate and detailed documentation of the NIHSS score upon patient arrival, including time of onset and any interventions initiated.

Common Clinical Scenarios

Patients arriving with acute stroke symptoms, requiring rapid assessment and intervention.

Billing Considerations

Document the time of symptom onset and any pre-hospital care to support acute treatment decisions.

Coding Guidelines

Inclusion Criteria

Use R29.724 When
  • Follow official coding guidelines for documenting neurological assessments and ensure that the NIHSS score is supported by clinical findings
  • The score must be clearly linked to the patient's clinical presentation and treatment plan

Exclusion Criteria

Do NOT use R29.724 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient with a NIHSS score of 24 is evaluated in the emergency department.

Documentation Requirements

Document the severity of the condition, NIHSS score, and any interventions performed.

Specialty Considerations

Emergency medicine providers should ensure timely documentation to support the high severity visit.

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. The detailed coding of NIHSS scores enhances the understanding of stroke outcomes and treatment effectiveness.

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. The detailed coding of NIHSS scores enhances the understanding of stroke outcomes and treatment effectiveness.

Reimbursement & Billing Impact

reimbursement processes. The detailed coding of NIHSS scores enhances the understanding of stroke outcomes and treatment effectiveness.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 24 indicate?

An NIHSS score of 24 indicates severe neurological impairment, often associated with significant deficits in motor function, language, and consciousness, requiring urgent medical intervention.