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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.7

R29.7

National Institutes of Health Stroke Scale (NIHSS) score

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

Code Description

ICD-10 R29.7 is a billable code used to indicate a diagnosis of national institutes of health stroke scale (nihss) score.

Key Diagnostic Point:

The National Institutes of Health Stroke Scale (NIHSS) score is a systematic assessment tool that quantifies the impairment caused by a stroke. It evaluates various aspects of neurological function, including consciousness, vision, motor function, sensation, language, and neglect. The total score ranges from 0 to 42, with lower scores indicating milder strokes and higher scores indicating more severe strokes. The NIHSS is crucial for determining the severity of a stroke, guiding treatment decisions, and predicting patient outcomes. It is commonly used in both acute and post-acute settings to monitor changes in a patient's condition over time. Accurate scoring requires thorough clinical evaluation and understanding of the scale's components, making it essential for healthcare providers to be well-trained in its application.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires comprehensive understanding of neurological assessment.
  • Variability in scoring based on clinical judgment.
  • Potential for misinterpretation of symptoms.
  • Documentation must reflect the exact NIHSS score.

Audit Risk Factors

  • Inconsistent documentation of NIHSS scores.
  • Failure to document the clinical context of the score.
  • Inaccurate scoring leading to incorrect coding.
  • Lack of correlation between NIHSS score and treatment provided.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments and NIHSS scores, including any changes over time.

Common Clinical Scenarios

Patients presenting with stroke symptoms, requiring assessment and monitoring of neurological function.

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Immediate and accurate documentation of NIHSS scores upon patient presentation and subsequent evaluations.

Common Clinical Scenarios

Acute stroke presentations requiring rapid assessment and intervention.

Billing Considerations

Timeliness of documentation is critical; ensure that the NIHSS score reflects the patient's condition at the time of evaluation.

Coding Guidelines

Inclusion Criteria

Use R29.7 When
  • According to ICD
  • 10 coding guidelines, R29
  • 7 should be used when documenting the NIHSS score as part of the clinical assessment of a stroke
  • It is important to ensure that the score is clearly documented in the medical record, along with the clinical context

Exclusion Criteria

Do NOT use R29.7 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient presents with acute stroke symptoms and requires a comprehensive evaluation.

Documentation Requirements

Document the NIHSS score and clinical findings to support the level of service.

Specialty Considerations

Emergency medicine providers must ensure timely and accurate documentation of the NIHSS.

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 assessments, including the NIHSS. This specificity improves data collection and analysis for stroke management and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke-related assessments, including the NIHSS. This specificity improves data collection and analysis for stroke management and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stroke-related assessments, including the NIHSS. This specificity improves data collection and analysis for stroke management and outcomes.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

When should R29.7 be used?

R29.7 should be used when documenting the NIHSS score as part of a stroke assessment, reflecting the patient's neurological status.