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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.719

R29.719

NIHSS score 19

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

Code Description

ICD-10 R29.719 is a billable code used to indicate a diagnosis of nihss score 19.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 19 indicates a severe stroke with significant neurological impairment. This score reflects a range of symptoms including but not limited to: altered consciousness, severe motor deficits, aphasia, and sensory loss. Patients scoring 19 typically exhibit profound deficits in both motor and cognitive functions, which may include difficulty in speech, inability to follow commands, and significant limb weakness. The NIHSS is a critical tool used in the assessment of stroke severity and helps guide treatment decisions. A score of 19 suggests that the patient requires immediate and intensive medical intervention, often in a hospital setting, to manage the acute effects of the stroke and to prevent further neurological damage. Accurate documentation of the NIHSS score is essential for coding and billing purposes, as it directly influences the treatment pathway and potential reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in clinical presentation of stroke symptoms
  • Need for precise documentation of neurological deficits
  • Potential for overlapping symptoms with other conditions
  • Importance of timely and accurate scoring

Audit Risk Factors

  • Inadequate documentation of NIHSS score
  • Failure to specify the severity of symptoms
  • Misinterpretation of NIHSS scoring criteria
  • Lack of correlation between documented symptoms and NIHSS score

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological examination findings, including NIHSS score and specific deficits observed.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms, requiring assessment and management in an inpatient setting.

Billing Considerations

Ensure that all neurological deficits are documented clearly to support the NIHSS score and justify the level of care provided.

Emergency Medicine

Documentation Requirements

Comprehensive documentation of initial assessment, including NIHSS score, vital signs, and any interventions performed.

Common Clinical Scenarios

Patients arriving at the emergency department with acute onset of neurological symptoms, requiring rapid assessment and intervention.

Billing Considerations

Timeliness of documentation is critical; ensure that the NIHSS score is recorded promptly to facilitate treatment decisions.

Coding Guidelines

Inclusion Criteria

Use R29.719 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and correlates with the clinical findings
  • Use additional codes to specify any underlying conditions or complications

Exclusion Criteria

Do NOT use R29.719 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used for patients with acute stroke symptoms requiring immediate evaluation and management.

Documentation Requirements

Document the NIHSS score, clinical findings, and any interventions performed.

Specialty Considerations

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

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 capture the complexity of patient presentations and improving the accuracy of reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity, enhancing the ability to capture the complexity of patient presentations and improving the accuracy of reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 19 indicate?

An NIHSS score of 19 indicates severe neurological impairment, suggesting significant deficits in motor and cognitive functions, and necessitating urgent medical intervention.