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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.727

R29.727

NIHSS score 27

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

Code Description

ICD-10 R29.727 is a billable code used to indicate a diagnosis of nihss score 27.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 27 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, and sensory perception. A score of 27 suggests that the patient exhibits profound deficits, such as severe aphasia, hemiplegia, and potentially altered consciousness. Patients with such high scores often require immediate and intensive medical intervention, including possible thrombolysis or mechanical thrombectomy, depending on the time of onset and other clinical factors. The NIHSS is crucial for guiding treatment decisions, predicting outcomes, and facilitating communication among healthcare providers. Accurate scoring and documentation are essential for appropriate coding and reimbursement, as well as for tracking the quality of care provided to stroke patients.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise understanding of NIHSS scoring criteria.
  • Involves interpretation of clinical findings and symptoms.
  • High variability in patient presentation and scoring.
  • Potential for misclassification of stroke severity.

Audit Risk Factors

  • Inadequate documentation of NIHSS assessment.
  • Failure to correlate NIHSS score with clinical findings.
  • Misinterpretation of stroke severity leading to incorrect coding.
  • Lack of follow-up documentation post-stroke intervention.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments and NIHSS scoring.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms requiring hospitalization.

Billing Considerations

Ensure that all components of the NIHSS are documented to support the score.

Emergency Medicine

Documentation Requirements

Immediate and thorough documentation of NIHSS score upon patient arrival.

Common Clinical Scenarios

Acute stroke presentations in the emergency department.

Billing Considerations

Timeliness of documentation is critical for treatment decisions.

Coding Guidelines

Inclusion Criteria

Use R29.727 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and correlates with clinical findings
  • Use additional codes to capture any underlying conditions or complications

Exclusion Criteria

Do NOT use R29.727 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used for patients presenting with severe stroke symptoms requiring immediate evaluation.

Documentation Requirements

Document the severity of symptoms and NIHSS score.

Specialty Considerations

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

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 data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    NIHSS Training and Resources

Coding & Billing References

  • •
    NIHSS Training and Resources

Frequently Asked Questions

What does a NIHSS score of 27 indicate?

A NIHSS score of 27 indicates severe neurological impairment, often associated with significant stroke-related deficits.