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Procedure code 96161 billing with Z13.32 for maternal depression

  1. Default Procedure code 96161 billing with Z13.32 for maternal depression
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    Is anyone having an issue billing the new Z13.32 for maternal depression? We screen all our newborn moms and bill the 96161 w/the new Z13.32 used to me Z13.4; now payers are denying for gender when baby is a male baby?? We are a pediatric provider and screen our moms as part of our meaningful use criteria. Thanks

  2. Default matefnal depression screening
    Hi, kellis1973 , for the maternal depression screening code 96161, we have in the past using Dx Z13.89. We only have a few payers that pay. Make sure that your are using the correct modifier when you bill your Medicaid insurances. If child gets vaccinations on the same date of service, make sure you are using modifier 59.

  3. Default
    From the research I have done on this particular diagnosis code, it is meant to be used only on the mother's record. I too have been using Z13.89 with success. Best of luck!

  4. #4
    Default
    According to American Academy of Pediatrics you use the appropriate Z00.129, Z00.121 Z00.110 or Z00.111

  5. #5
    Default 96161 icd z13.32
    i am reading this should replace ICD Z13.89 as of Oct 2018. However, it should be billed under mom's name and ID? Makes no sense when you are the servicing provider for the infant. Looking for answers.

  6. Default dheino
    I agree with Amcilwain. I to work in a Pediatric office and the Z13.32 is a female only code (in my ICD book it has the female sign next to the code). We also bill ours out to the Z00.110, Z00.111 and Z00.129.

  7. #7
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    Columbia, MO
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    It is a female only code because it is the mom being screened for maternal depression not the baby.. you need to be billing this under the mom name and ID not the baby's. You do not provide service to the mother and bill it as a well baby visit.

    Debra A. Mitchell, MSPH, CPC-H

  8. Default billing for 96161
    Quote Originally Posted by kellis1973 View Post
    Is anyone having an issue billing the new Z13.32 for maternal depression? We screen all our newborn moms and bill the 96161 w/the new Z13.32 used to me Z13.4; now payers are denying for gender when baby is a male baby?? We are a pediatric provider and screen our moms as part of our meaningful use criteria. Thanks

    Hi,

    Many Medicaid plans and some other health plans do pay for 96161 as a service to the infant. Be sure to check the individual payer's policy and as noted, on the infant's claim, code Z13.32 is not reported. Link the appropriate routine child health exam ICD-10 code to 96161. Also, be aware of NCCI edits that bundle 96161 with immunization administration codes but should allow a modifier to bypass the edit.

    Best wishes,
    Cindy

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