Question Maternal Depression in Pediatric Coding

MCogdill

Contributor
Messages
23
Best answers
0
Please help! I work in a pediatric office. One of the providers wants to verify coding for Edinburgh maternal survey that is positive for depression. Sometimes they put an 'O' code that slips past billing when posting charges, which of course gets returned unprocessed.

As far as I am aware we code the survey and document mom needs to follow up with her PCP. The providers either want to use F53.0 (maternal depression) which I believe should only be used for mom. There is also Z63.79 " Stressful life events affecting family and household"

I am not sure we need to code anything for this, just the documentation. But being new to this type of practice I want to be sure.

Thanks in advance
 

kpeterson15

Networker
Messages
54
Best answers
0
Question to clarify, the physician wants to give the child a F53.0 code for his/her diagnosis code? That is what I am assuming since you are in a pediatric office. That seems like a weird code to give a child. How old is the child? Also, what is the exact wording the physician used in his documentation for the diagnosis?? If I have the exact wording, I may be able to help more. :)

With more reading I just did, maternal depression can have an impact on the child, but I would code that impact in had on him/her and would not code maternal depression for a child.
 
Last edited:

MCogdill

Contributor
Messages
23
Best answers
0
Question to clarify, the physician wants to give the child a F53.0 code for his/her diagnosis code? That is what I am assuming since you are in a pediatric office. That seems like a weird code to give a child. How old is the child? Also, what is the exact wording the physician used in his documentation for the diagnosis?? If I have the exact wording, I may be able to help more. :)

With more reading I just did, maternal depression can have an impact on the child, but I would code that impact in had on him/her and would not code maternal depression for a child.
The screening is done the 1st 6 months. I don't think there is a code to add UNLESS it actually affects the baby, which I believe is a Z code...??
 

kpeterson15

Networker
Messages
54
Best answers
0
The screening is done the 1st 6 months. I don't think there is a code to add UNLESS it actually affects the baby, which I believe is a Z code...??
Yes, I would not code anything having to do with the mom since they are there to check on the baby and not the mom. The mom PCP would be coding for maternal depression. You code use a Z code only if the physician says the mom's depression has an impact on the baby's care, and even then it would be a iffy code. I would just code for a routine check-up and if any abnormalities were found during the baby's check-up! :)
 
Messages
381
Best answers
0
Unless the physician is creating a chart for the mother and addressing the positive screening (eg, counseling the mother and coordinating follow-up with another provider), the depression screening is reported with the routine child health exam code (Z00.121 or Z00.129) and code 96161 (administration of caregiver-focused health risk assessment [eg, depression inventory] for the benefit of the patient, with scoring and documentation, per standardized instrument). However, if the physician creates a chart for the mother (a physician specializing in pediatrics is still a physician who can treat adults in most states), a code for depression screening Z13.32 and procedure codes 96127 and an E/M based on the MDM or time (separate from care of the infant) may be reported to the mother's health plan. It is not appropriate to report F53.0 or Z13.32 on the infant's claim.

Be sure to check health plan policy for how to bill for maternal depression screening during a routine infant well exam as they do vary on the coverage and codes required (especially Medicaid plans).

Cindy
 

MCogdill

Contributor
Messages
23
Best answers
0
Yes, I would not code anything having to do with the mom since they are there to check on the baby and not the mom. The mom PCP would be coding for maternal depression. You code use a Z code only if the physician says the mom's depression has an impact on the baby's care, and even then it would be a iffy code. I would just code for a routine check-up and if any abnormalities were found during the baby's check-up! :)
That is what I was telling them but I wanted some extra ammo. Thank you!
 

MCogdill

Contributor
Messages
23
Best answers
0
Unless the physician is creating a chart for the mother and addressing the positive screening (eg, counseling the mother and coordinating follow-up with another provider), the depression screening is reported with the routine child health exam code (Z00.121 or Z00.129) and code 96161 (administration of caregiver-focused health risk assessment [eg, depression inventory] for the benefit of the patient, with scoring and documentation, per standardized instrument). However, if the physician creates a chart for the mother (a physician specializing in pediatrics is still a physician who can treat adults in most states), a code for depression screening Z13.32 and procedure codes 96127 and an E/M based on the MDM or time (separate from care of the infant) may be reported to the mother's health plan. It is not appropriate to report F53.0 or Z13.32 on the infant's claim.

Be sure to check health plan policy for how to bill for maternal depression screening during a routine infant well exam as they do vary on the coverage and codes required (especially Medicaid plans).

Cindy
Thanks so much
 
Top