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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.726

R29.726

NIHSS score 26

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

Code Description

ICD-10 R29.726 is a billable code used to indicate a diagnosis of nihss score 26.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 26 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 26 suggests that the patient exhibits profound deficits, such as severe aphasia, hemiplegia, and potentially altered consciousness. Patients with such high scores often require immediate and intensive medical intervention, including possible thrombolytic therapy or surgical intervention. The NIHSS is crucial for determining the severity of a stroke, guiding treatment decisions, and predicting patient outcomes. Accurate scoring and documentation are essential for effective treatment planning and for coding purposes, as they directly influence the reimbursement process and quality of care assessments.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise understanding of NIHSS scoring criteria.
  • Involves interpretation of clinical findings and symptoms.
  • High variability in patient presentation and scoring.
  • Potential for misclassification of stroke severity.

Audit Risk Factors

  • Inadequate documentation of NIHSS assessment.
  • Failure to link NIHSS score to clinical findings.
  • Misinterpretation of NIHSS components leading to incorrect scoring.
  • Inconsistent scoring across different assessments.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with acute stroke symptoms, requiring NIHSS evaluation.

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Immediate documentation of NIHSS score upon patient presentation and any interventions performed.

Common Clinical Scenarios

Acute stroke presentations requiring rapid assessment and intervention.

Billing Considerations

Timeliness of documentation is critical; ensure that the NIHSS score is recorded promptly.

Coding Guidelines

Inclusion Criteria

Use R29.726 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and correlates with clinical findings
  • The score should be linked to the primary diagnosis of stroke or transient ischemic attack (TIA)

Exclusion Criteria

Do NOT use R29.726 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 26 is evaluated in the emergency department.

Documentation Requirements

Document the severity of the condition and the NIHSS score.

Specialty Considerations

Emergency medicine providers should ensure timely documentation of the NIHSS score.

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 reimbursement 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 reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    NIHSS Training and Certification

Coding & Billing References

  • •
    NIHSS Training and Certification

Frequently Asked Questions

What does an NIHSS score of 26 indicate?

An NIHSS score of 26 indicates severe neurological impairment, often associated with significant stroke, requiring urgent medical intervention.