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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.722

R29.722

NIHSS score 22

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

Code Description

ICD-10 R29.722 is a billable code used to indicate a diagnosis of nihss score 22.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 22 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, and sensory perception. A score of 22 suggests that the patient exhibits profound deficits in multiple areas, which may include severe aphasia, hemiparesis, and altered consciousness. Clinically, patients with such a score often require immediate and intensive medical intervention, including potential thrombolysis or mechanical thrombectomy, depending on the time since symptom onset. The NIHSS is a critical tool in both acute stroke management and research, providing a standardized method to quantify the degree of neurological impairment and guide treatment decisions. Accurate scoring is essential for effective patient management and for assessing outcomes in clinical trials.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of the NIHSS scoring system
  • Involves interpretation of clinical findings
  • Potential for variability in scoring among clinicians
  • Need for comprehensive documentation of neurological deficits

Audit Risk Factors

  • Inconsistent scoring among healthcare providers
  • Incomplete documentation of neurological assessments
  • Failure to link NIHSS score to specific clinical findings
  • Misinterpretation of the severity of symptoms

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments, including NIHSS scoring and clinical findings.

Common Clinical Scenarios

Patients presenting with acute ischemic stroke symptoms, requiring hospitalization and management.

Billing Considerations

Ensure that all neurological deficits are documented to support the NIHSS score and the need for acute interventions.

Emergency Medicine

Documentation Requirements

Thorough documentation of initial assessment, including NIHSS score, vital signs, and any imaging results.

Common Clinical Scenarios

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

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use R29.722 When
  • Follow official ICD
  • CM guidelines for coding symptoms and signs
  • Ensure that the NIHSS score is supported by clinical documentation and that it reflects the patient's current condition accurately

Exclusion Criteria

Do NOT use R29.722 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient with a NIHSS score of 22 is evaluated in the emergency department.

Documentation Requirements

Document the patient's presenting symptoms, NIHSS score, and any interventions performed.

Specialty Considerations

Emergency medicine providers should ensure timely 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, enabling better tracking of patient outcomes and resource utilization in stroke care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity, enabling better tracking of patient outcomes and resource utilization in stroke care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stroke severity, enabling better tracking of patient outcomes and resource utilization in stroke care.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does a NIHSS score of 22 indicate?

A NIHSS score of 22 indicates severe neurological impairment, often requiring immediate medical intervention and intensive care.