ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesR29.721

R29.721

NIHSS score 21

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

Code Description

ICD-10 R29.721 is a billable code used to indicate a diagnosis of nihss score 21.

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 21 indicates a severe level of impairment, suggesting significant neurological deficits that may include altered consciousness, severe motor weakness, and profound sensory loss. Patients with this score often exhibit symptoms such as aphasia, neglect, and visual field deficits. The NIHSS is crucial for determining the severity of a stroke, guiding treatment decisions, and predicting patient outcomes. A score of 21 typically correlates with a high risk of complications and a need for intensive rehabilitation services. Accurate assessment and documentation of the NIHSS score are essential for appropriate coding and billing, as it reflects the patient's clinical status and the complexity of care required.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in clinical presentation of stroke symptoms
  • Need for precise scoring based on clinical assessment
  • Potential for misinterpretation of NIHSS scores
  • Documentation requirements for severity and treatment

Audit Risk Factors

  • Inconsistent documentation of NIHSS scores
  • Failure to link NIHSS scores to specific clinical findings
  • Inaccurate coding of stroke severity
  • Lack of supporting documentation for treatment decisions

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments, NIHSS scores, and treatment plans.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms requiring hospitalization and management.

Billing Considerations

Ensure comprehensive documentation of all neurological deficits and their impact on patient care.

Emergency Medicine

Documentation Requirements

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

Common Clinical Scenarios

Acute stroke presentations requiring rapid assessment and intervention.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use R29.721 When
  • Follow official coding guidelines for the use of R29
  • 721, ensuring that the NIHSS score is documented accurately and linked to the patient's clinical presentation and treatment plan

Exclusion Criteria

Do NOT use R29.721 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used for patients presenting with acute stroke symptoms and NIHSS score of 21.

Documentation Requirements

Detailed documentation of the patient's condition, NIHSS score, and treatment provided.

Specialty Considerations

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

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 related conditions, improving the accuracy of patient records and billing processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity and related conditions, improving the accuracy of patient records and billing processes.

Reimbursement & Billing Impact

billing processes.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 21 indicate?

An NIHSS score of 21 indicates severe neurological impairment, suggesting significant deficits that may require intensive medical intervention and rehabilitation.