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v1.0.0
ICD-10 Guide
ICD-10 CodesR29.742

R29.742

NIHSS score 42

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

Code Description

ICD-10 R29.742 is a billable code used to indicate a diagnosis of nihss score 42.

Key Diagnostic Point:

The NIHSS (National Institutes of Health Stroke Scale) score of 42 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 42 suggests that the patient exhibits profound deficits across multiple domains, potentially including unresponsiveness, inability to follow commands, and severe motor weakness. Such a high score is indicative of a critical condition requiring immediate medical intervention and often correlates with a poor prognosis. The NIHSS is a standardized tool used by healthcare professionals to evaluate the severity of a stroke and guide treatment decisions. Accurate scoring and documentation are essential for effective patient management and for coding purposes, as they provide a clear picture of the patient's clinical status and the urgency of care required.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Interpretation of NIHSS scores can vary among clinicians.
  • Documentation must clearly reflect the severity indicated by the score.
  • High stakes in coding due to potential implications for treatment and reimbursement.
  • Need for comprehensive clinical context to justify the score.

Audit Risk Factors

  • Inadequate documentation of the NIHSS assessment.
  • Failure to link the NIHSS score to the clinical findings.
  • Misinterpretation of the score leading to incorrect coding.
  • Lack of clarity on the patient's neurological status.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of neurological assessments and NIHSS scoring.

Common Clinical Scenarios

Patients presenting with stroke symptoms, requiring 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 R29.742 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the NIHSS score is documented accurately and linked to the clinical findings
  • The score should reflect the patient's current condition and be supported by the clinical narrative

Exclusion Criteria

Do NOT use R29.742 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 intervention.

Documentation Requirements

Document the severity of the condition and the 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, improving the accuracy of patient records and treatment planning. R29.742 provides a clear indication of severe neurological impairment, which is critical for appropriate management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of stroke severity, improving the accuracy of patient records and treatment planning. R29.742 provides a clear indication of severe neurological impairment, which is critical for appropriate management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of stroke severity, improving the accuracy of patient records and treatment planning. R29.742 provides a clear indication of severe neurological impairment, which is critical for appropriate management.

Resources

Clinical References

  • •
    NIH Stroke Scale Training

Coding & Billing References

  • •
    NIH Stroke Scale Training

Frequently Asked Questions

What does a NIHSS score of 42 indicate?

A NIHSS score of 42 indicates severe neurological impairment, often associated with a critical stroke requiring immediate medical attention.