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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.709

R29.709

NIHSS score 9

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

Code Description

ICD-10 R29.709 is a billable code used to indicate a diagnosis of nihss score 9.

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 9 indicates moderate stroke severity, reflecting significant impairment in neurological function. Patients with this score may exhibit symptoms such as facial droop, arm weakness, speech difficulties, and sensory loss. The NIHSS is crucial for determining treatment options and predicting patient outcomes. A score of 9 suggests that the patient may require urgent medical intervention, including possible thrombolysis or mechanical thrombectomy, depending on the time since symptom onset. Accurate assessment and documentation of the NIHSS score are vital for appropriate coding and treatment planning, as it directly influences clinical decisions and resource allocation in acute stroke management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for precise documentation of neurological deficits
  • Potential for overlapping symptoms with other conditions
  • Importance of timely assessment in acute settings

Audit Risk Factors

  • Inadequate documentation of NIHSS assessment
  • Failure to specify the time of symptom onset
  • Misinterpretation of NIHSS scores leading to incorrect coding
  • Lack of correlation between documented symptoms and NIHSS score

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments, including NIHSS scores and corresponding symptoms.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms, requiring hospitalization for further evaluation and management.

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Immediate and thorough documentation of NIHSS scores upon patient arrival, including time of onset and any interventions initiated.

Common Clinical Scenarios

Patients arriving at the emergency department with acute stroke symptoms, requiring rapid assessment and treatment.

Billing Considerations

Timeliness of documentation is critical; delays can impact treatment decisions and coding accuracy.

Coding Guidelines

Inclusion Criteria

Use R29.709 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and correlates with the clinical findings
  • The code should be used when the NIHSS score is specifically assessed and recorded

Exclusion Criteria

Do NOT use R29.709 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient with an NIHSS score of 9 presents to the emergency department.

Documentation Requirements

Document the NIHSS score, time of onset, and clinical findings.

Specialty Considerations

Emergency medicine providers should 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, enhancing the ability to track outcomes and improve patient care. R29.709 provides a clear indication of moderate stroke severity, facilitating better resource allocation and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity, enhancing the ability to track outcomes and improve patient care. R29.709 provides a clear indication of moderate stroke severity, facilitating better resource allocation and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stroke severity, enhancing the ability to track outcomes and improve patient care. R29.709 provides a clear indication of moderate stroke severity, facilitating better resource allocation and treatment planning.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 9 indicate?

An NIHSS score of 9 indicates moderate stroke severity, reflecting significant neurological impairment that may require urgent medical intervention.