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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.725

R29.725

NIHSS score 25

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

Code Description

ICD-10 R29.725 is a billable code used to indicate a diagnosis of nihss score 25.

Key Diagnostic Point:

The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. A score of 25 indicates a severe level of impairment, reflecting significant neurological deficits that may include altered consciousness, severe motor weakness, and profound sensory loss. Patients scoring 25 typically exhibit symptoms such as inability to follow commands, facial droop, arm and leg weakness, and possible aphasia. This score is crucial in determining the urgency of treatment and the potential for recovery. It is often used in clinical settings to assess the severity of a stroke and guide therapeutic decisions. Accurate scoring and documentation are essential for appropriate coding and treatment planning, as a high NIHSS score correlates with a higher risk of complications and poorer outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Interpretation of NIHSS scores can vary among clinicians.
  • Documentation must clearly reflect the severity of symptoms.
  • Differentiating between stroke types may complicate coding.
  • Need for comprehensive clinical context to justify the score.

Audit Risk Factors

  • Inadequate documentation of the NIHSS assessment.
  • Failure to link the NIHSS score to the clinical diagnosis.
  • Misinterpretation of the NIHSS score leading to incorrect coding.
  • Lack of clarity on the patient's functional status post-stroke.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments, including NIHSS scores and clinical findings.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms requiring hospitalization and evaluation.

Billing Considerations

Ensure that all neurological deficits are documented to support the NIHSS score.

Emergency Medicine

Documentation Requirements

Immediate documentation of NIHSS scores upon patient presentation and any changes during treatment.

Common Clinical Scenarios

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

Billing Considerations

Timeliness of documentation is critical; ensure that all assessments are recorded promptly.

Coding Guidelines

Inclusion Criteria

Use R29.725 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented in the medical record and correlates with the clinical findings and diagnosis

Exclusion Criteria

Do NOT use R29.725 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient with a high NIHSS score presents to the emergency department.

Documentation Requirements

Document the severity of symptoms and the NIHSS score.

Specialty Considerations

Emergency medicine providers should ensure timely and accurate documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of stroke-related symptoms and assessments, improving the accuracy of clinical data and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke-related symptoms and assessments, improving the accuracy of clinical data and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 25 indicate?

An NIHSS score of 25 indicates severe neurological impairment, often associated with significant deficits in motor function, language, and consciousness.