December 5, 2019
Research has shown perinatal depression is a common condition that is estimated to affect more than 180,000 new mothers annually in the United States and that can have a devastating effect on the mother and the infant.
Perinatal depression is defined as the occurrence of a major or minor depressive episode during pregnancy or up to 1 year after childbirth. Feeling hopeless, loss of interest in activities that used to be enjoyed and withdrawing from friends and family are typical symptoms of depressive disorders. Other symptoms in the perinatal period may include persistent doubt of the ability to take care of the infant, trouble bonding with the infant, and thoughts of self-harm or harm of the infant.
Starting January 1, 2020, Premera will be covering interventions to prevent perinatal depression. For pregnant and postpartum persons who are at increased risk of perinatal depression, providers are asked to deliver or refer to counseling interventions. Screening for perinatal depression can also occur during a well-baby checkup.
Codes for interventions to prevent perinatal depression:
| CPT codes |
ICD10 Diagnosis code |
Frequency Limitations |
Comments |
| Screening codes |
Z13.32 |
No |
|
| 96161 – Health risk assessment/Intervention |
Currently in system to pay as preventive |
| 96127 – Brief emotional/behavioral assessment |
| Therapy Codes |
|
| 90832 – Psychotherapy, 30 minutes with patient |
|
| 90834 – Psychotherapy, 45 (38-52) minutes with patient |
|
| 90837 – Psychotherapy, 60 (at least 53) minutes with patient |
|
| 90847- Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes |
|
| 90853 – Group psychotherapy (other than a multiple-family group) |
Yes – limited to 1x per day |
Payment Policy exists – Group Psychotherapy Services (90853) |
| Telehealth |
|
|
| All codes listed above billed with modifiers
|
No limitations for codes listed except 90853 - billed with any modifier – limited to 1 X day
Invalid code combinations:
- 96161 95
- 96127 95
- 96127 GT
- 96127 GQ
- 90853 95
90853 – billed with modifiers GT or GQ – limited to 1 X day
|
Place of Service be 02 |