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Pediatric Behavioral Health Visit for Maternal Grief/Anxiety

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bleak1994

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High Point, NC
I have a behavioral health visit that was done under a 2 year old's chart. The mom came in because she is struggling with depression and elevated anxiety (according to the provider's notes) due to the loss of two siblings. The provider originally billed 90832 with Z63.79 which denied. Does anyone have any suggestions about other diagnosis codes that could be used?
 
Are you saying that the mother's depression/anxiety was treated by a pediatrician under the child's account? Maybe I read this wrong. I hope so.

If you check your ICD-10-CM book (if you have the expert copy), you'll note that Z63.79 is an unacceptable primary diagnosis. The reason for the visit appears to be depression and anxiety. That is what should be coded.

However, finding the right diagnosis is the least of your problems. The pediatrician is outside his/her scope of practice if he treated mom for a behavioral health condition, and you should never bill the mom's care under the kid.
 
The provider is a Behavioral Health clinician. She is located at a Pediatric site. Yes, the mother was seen under the child's account.

I came across this claim due to the denial received. I reached out to the LCSW and explained that mom needs to be a patient at another location. I needed clarity to make sure I told her the correct information.

Thank you so much for your response! I have reached out to the LCSW to explain again.
 
Last edited:
bleak1994 said:
The provider is a Behavioral Health clinician. She is located at a Pediatric site. Yes, the mother was seen under the child's account.

I came across this claim due to the denial received. I reached out to the LCSW and explained that mom needs to be a patient at another location. I needed clarity to make sure I told her the correct information.

Thank you so much for your response! I have reached out to the LCSW to explain again.
Click to expand...
If the services were provided to the mother and it is not a family session for the child mentioned above, then this would need to be billed as treatment for the mother.
 
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