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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.739

R29.739

NIHSS score 39

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

Code Description

ICD-10 R29.739 is a billable code used to indicate a diagnosis of nihss score 39.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 39 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, sensory perception, and visual fields. A score of 39 suggests profound deficits, potentially including complete loss of motor function on one side of the body, severe aphasia, and altered consciousness. Patients with such high scores often require immediate medical intervention and intensive rehabilitation services. 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 resource allocation in acute care settings.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • High level of clinical detail required for accurate scoring.
  • Variability in patient presentation and response to treatment.
  • Need for comprehensive documentation to support the score.
  • Potential for misinterpretation of neurological findings.

Audit Risk Factors

  • Inconsistent documentation of neurological assessments.
  • Failure to capture the full extent of neurological deficits.
  • Inaccurate scoring leading to misrepresentation of patient severity.
  • Lack of clarity in the relationship between symptoms and the NIHSS score.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed neurological examination notes, including NIHSS scoring and patient history.

Common Clinical Scenarios

Patients presenting with acute stroke symptoms, requiring hospitalization and monitoring.

Billing Considerations

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

Emergency Medicine

Documentation Requirements

Immediate assessment documentation, including NIHSS score and interventions initiated.

Common Clinical Scenarios

Acute stroke presentations requiring rapid assessment and treatment.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use R29.739 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the NIHSS score is accurately documented and reflects the patient's clinical status
  • Use additional codes to capture related conditions or complications as necessary

Exclusion Criteria

Do NOT use R29.739 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 is evaluated in 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, improving the accuracy of patient records and facilitating better care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke-related conditions, improving the accuracy of patient records and facilitating better care management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stroke-related conditions, improving the accuracy of patient records and facilitating better care management.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does an NIHSS score of 39 indicate?

An NIHSS score of 39 indicates severe neurological impairment, often associated with significant deficits in motor function, language, and consciousness.