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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.730

R29.730

NIHSS score 30

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

Code Description

ICD-10 R29.730 is a billable code used to indicate a diagnosis of nihss score 30.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 30 indicates a severe stroke with significant neurological impairment. This score reflects a high level of disability, with patients typically exhibiting profound deficits in consciousness, motor function, language, and sensory perception. Common symptoms associated with a NIHSS score of 30 include complete hemiplegia, inability to follow commands, and severe aphasia or dysarthria. Patients may also present with altered mental status, facial droop, and neglect of one side of the body. The NIHSS is a critical tool used in the assessment of stroke severity and helps guide treatment decisions. A score of 30 suggests that the patient is at high risk for complications and may require intensive medical intervention, rehabilitation, and monitoring. Accurate documentation of the NIHSS score and associated clinical findings is essential for appropriate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of neurological deficits.
  • Involves understanding of stroke severity scales.
  • Potential for misclassification if not properly documented.
  • High variability in clinical presentation.

Audit Risk Factors

  • Inadequate documentation of NIHSS assessments.
  • Failure to correlate clinical findings with the NIHSS score.
  • Misinterpretation of the severity of symptoms.
  • Inconsistent coding practices across providers.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed neurological assessments and NIHSS scores must be documented in the patient's medical record.

Common Clinical Scenarios

Patients presenting with acute ischemic stroke or hemorrhagic stroke requiring hospitalization.

Billing Considerations

Ensure that all neurological deficits are documented to support the NIHSS score.

Emergency Medicine

Documentation Requirements

Immediate documentation of NIHSS score upon patient presentation and any changes during treatment.

Common Clinical Scenarios

Acute stroke presentations requiring rapid assessment and intervention.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use R29.730 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented accurately and correlates with clinical findings
  • Use additional codes to specify any underlying conditions or complications

Exclusion Criteria

Do NOT use R29.730 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used for patients with a NIHSS score of 30 presenting to the emergency department.

Documentation Requirements

Document the severity of symptoms and NIHSS score.

Specialty Considerations

Emergency medicine providers must ensure timely and accurate documentation.

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 associated symptoms, 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 associated symptoms, 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 a NIHSS score of 30 indicate?

A NIHSS score of 30 indicates severe neurological impairment, often associated with significant disability and high risk for complications.