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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.733

R29.733

NIHSS score 33

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

Code Description

ICD-10 R29.733 is a billable code used to indicate a diagnosis of nihss score 33.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 33 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 33 suggests profound deficits, often associated with extensive brain damage, typically seen in cases of large vessel occlusion or hemorrhagic strokes. Patients may exhibit symptoms such as severe aphasia, hemiplegia, and altered consciousness. The NIHSS is crucial for determining treatment options, prognosis, and the need for rehabilitation services. Accurate scoring and documentation are essential for appropriate coding and billing, as they directly influence patient management and resource allocation in acute care settings.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise understanding of the NIHSS scoring system.
  • Involves interpretation of clinical findings and their implications.
  • Documentation must reflect the severity of symptoms accurately.
  • Potential for misclassification if not all symptoms are documented.

Audit Risk Factors

  • Inadequate documentation of NIHSS components.
  • Failure to link the NIHSS score to the clinical diagnosis.
  • Misinterpretation of the score leading to incorrect coding.
  • Lack of clarity on the patient's functional status post-stroke.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments, including NIHSS components and patient history.

Common Clinical Scenarios

Patients presenting with stroke symptoms, requiring comprehensive evaluation and management.

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Immediate and thorough documentation of NIHSS score upon patient presentation.

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 R29.733 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the NIHSS score is documented in the medical record and correlates with the clinical diagnosis of stroke
  • The score should be clearly linked to the patient's presenting symptoms and clinical findings

Exclusion Criteria

Do NOT use R29.733 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used for patients presenting with severe stroke symptoms requiring immediate care.

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, enhancing the ability to capture the complexity of stroke management and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity and associated symptoms, enhancing the ability to capture the complexity of stroke management and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stroke severity and associated symptoms, enhancing the ability to capture the complexity of stroke management and outcomes.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 33 indicate?

An NIHSS score of 33 indicates severe neurological impairment, often associated with significant brain damage and a poor prognosis.