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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 CodesR29.734

R29.734

NIHSS score 34

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

Code Description

ICD-10 R29.734 is a billable code used to indicate a diagnosis of nihss score 34.

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 34 indicates a severe stroke, reflecting significant impairment in multiple areas including consciousness, language, motor function, and sensory perception. Patients with such a high score typically exhibit profound weakness or paralysis, altered consciousness, and may require immediate medical intervention. The NIHSS is crucial for determining the severity of the stroke, guiding treatment decisions, and predicting patient outcomes. It is essential for coders to understand the implications of a high NIHSS score, as it correlates with increased morbidity and mortality rates. Accurate documentation of the NIHSS score, along with the clinical findings that led to this assessment, is vital for appropriate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Interpretation of NIHSS scores requires clinical expertise.
  • High variability in patient presentation and comorbidities.
  • Documentation must clearly reflect the severity of symptoms.
  • Differentiating between stroke types may complicate coding.

Audit Risk Factors

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

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

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

Common Clinical Scenarios

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

Billing Considerations

Ensure that all relevant comorbidities and their impact on the NIHSS score are documented.

Emergency Medicine

Documentation Requirements

Immediate and thorough documentation of NIHSS scores upon patient presentation.

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 R29.734 When
  • Coders should refer to the official ICD
  • CM guidelines for coding symptoms, signs, and abnormal clinical findings
  • Accurate coding requires linking the NIHSS score to the clinical scenario and ensuring that all relevant documentation supports the severity indicated by the score

Exclusion Criteria

Do NOT use R29.734 When
No specific exclusions found.

Related CPT Codes

99285CPT Code

Emergency department visit, high severity

Clinical Scenario

Used when a patient with a high NIHSS score presents to the emergency department.

Documentation Requirements

Document the severity of symptoms and the NIHSS score.

Specialty Considerations

Emergency medicine providers should 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-related conditions, including the use of NIHSS scores to reflect severity. This specificity aids in better patient management and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke-related conditions, including the use of NIHSS scores to reflect severity. This specificity aids in better patient management and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    NIHSS Training and Resources

Coding & Billing References

  • •
    NIHSS Training and Resources

Frequently Asked Questions

What does a NIHSS score of 34 indicate?

A NIHSS score of 34 indicates severe neurological impairment, often associated with significant morbidity and mortality. It reflects the need for immediate medical intervention.