NIHSS score 5

This code indicates a National Institutes of Health Stroke Scale (NIHSS) score of 5, reflecting a mild to moderate neurological deficit following a stroke or other acute neurological event. The NIHSS is a systematic assessment tool used to quantify the severity of neurological impairment. A score of 5 suggests noticeable but not severely disabling deficits, potentially affecting areas such as motor function, language, or level of consciousness.

This code is used when a patient's NIHSS score is documented as 5 during an acute neurological assessment, typically in the context of ischemic stroke, hemorrhagic stroke, or transient ischemic attack (TIA). Documentation must clearly state the NIHSS score as 5, often found in emergency department notes, neurology consultations, or inpatient progress notes. It is frequently reported alongside the specific stroke diagnosis.

• Always ensure the NIHSS score of 5 is explicitly documented by the clinician.
• This code should be sequenced after the primary diagnosis for the acute neurological event (e.g., ischemic stroke).
• Do not use this code if the NIHSS score is not precisely 5; specific codes exist for other score ranges.