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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.737

R29.737

NIHSS score 37

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

Code Description

ICD-10 R29.737 is a billable code used to indicate a diagnosis of nihss score 37.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 37 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 37 suggests profound deficits, such as inability to follow commands, severe motor weakness, and potential loss of consciousness. Patients with such a high NIHSS score often present with acute symptoms like sudden weakness on one side of the body, difficulty speaking, or loss of coordination. The clinical context typically involves an acute ischemic stroke or hemorrhagic stroke, necessitating immediate medical intervention. The NIHSS score is crucial for determining treatment options, prognosis, and the need for rehabilitation services. Accurate documentation of the NIHSS score and associated clinical findings is essential for appropriate coding and billing.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of neurological deficits.
  • Involves understanding of stroke severity and treatment implications.
  • Potential for misinterpretation of NIHSS scores.
  • Need for correlation with clinical findings and imaging results.

Audit Risk Factors

  • Inadequate documentation of NIHSS assessment.
  • Failure to correlate NIHSS score with clinical findings.
  • Misclassification of stroke type or severity.
  • Inconsistent coding practices across providers.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Management of stroke patients in inpatient settings, including monitoring and rehabilitation planning.

Billing Considerations

Ensure comprehensive documentation of all neurological deficits and treatment responses.

Emergency Medicine

Documentation Requirements

Immediate documentation of NIHSS scores upon patient presentation and any interventions performed.

Common Clinical Scenarios

Acute stroke presentations requiring rapid assessment and intervention.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use R29.737 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and correlates with the clinical presentation
  • Use additional codes to specify the type of stroke and any associated complications

Exclusion Criteria

Do NOT use R29.737 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 and high NIHSS scores.

Documentation Requirements

Document the severity of symptoms, NIHSS score, and any immediate interventions.

Specialty Considerations

Emergency medicine providers must ensure timely and accurate documentation to support the level of service.

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 and associated symptoms, 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 severity and associated symptoms, improving the accuracy of clinical data and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    NIHSS Training and Certification

Coding & Billing References

  • •
    NIHSS Training and Certification

Frequently Asked Questions

What does a NIHSS score of 37 indicate?

A NIHSS score of 37 indicates severe neurological impairment, often associated with significant stroke events requiring immediate medical attention.