The head bolt size is the fool proof way. However, if you think your looking at a pretty unmolested truck, there are easier visual clues that will tell you real quick. It is usually the sum of these features more than any one individual feature.
All of the below screem 7.3!
Serp belt
Glow plug controller and bullet style GP's.
extra screw on the IP
gear tower oil fill
uncluttered passenger side wheel well cover
Engine harness connector on drivers side.
Basically a 6.9 is going to have the opposite of those
V belts
spade term glow plugs and disconnected GPC
plain IP
Oil fill bolted on the front of the gear tower
wires everywhere on the passenger side
no wires between engine and drivers side