2024 ICD-10-CM Diagnosis Code Z13.32

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• Diagnoses for females only - The Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, these edits apply to FEMALES only .
• Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Present on Admission (POA)

Z13.32 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.

CMS POA Indicator Options and Definitions

POA Indicator	Reason for Code	CMS will pay the CC/MCC DRG?
Y	Diagnosis was present at time of inpatient admission.	YES
N	Diagnosis was not present at time of inpatient admission.	NO
U	Documentation insufficient to determine if the condition was present at the time of inpatient admission.	NO
W	Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.	YES
1	Unreported/Not used - Exempt from POA reporting.	NO

Replacement Code

Z1332 replaces the following previously assigned ICD-10-CM code(s):

• Z13.8 - Encounter for screening for oth diseases and disorders

Patient Education

Postpartum Depression Screening

What is a postpartum depression screening?

Postpartum means "after birth." A postpartum depression screening is a set of questions you answer. Your health care provider uses the screening to help find out if you have developed depression related to having a baby.

Postpartum depression is different than the "baby blues." With the baby blues, you may feel sad, weepy, or anxious starting about three days after childbirth. These feelings tend to come and go, and usually get better on their own within a week or two. But postpartum depression is a serious mood disorder that may last for months and may not get better without treatment.

Symptoms of postpartum depression usually start between one to three weeks after birth. But they can begin anytime during the first year after your baby is born. The symptoms are more intense than the baby blues and may include extreme hopelessness and a lack of interest in the baby. Postpartum depression can affect your health and your baby's development, too.

Depression after birth is common, but it's not a regular part of having a baby. It may have more than one cause. Sudden changes in hormone levels that happen after a pregnancy may be involved. Lack of sleep, stress from new routines, and other changes may also play a role in triggering postpartum depression.

A postpartum depression screening helps diagnose the condition so it can be treated early. And early treatment can help prevent long-lasting depression. Most people get better with medicine and/or talk therapy. In the most serious cases, treatment may include brain stimulation therapies, such as electroconvulsive therapy (ECT), also called "shock therapy."

Other names: postpartum depression assessment, EPDS test

What is it used for?

A postpartum depression screening is used to help find out if you have depression after giving birth. The screening is often used as part of a routine checkup a few weeks after your baby is born. The test may be repeated to check for depression symptoms that may develop later.

Why do I need postpartum depression screening?

Anyone who has had a baby can develop postpartum depression. So, medical experts recommend screening for depression as part of routine care after childbirth. But if you have symptoms of postpartum depression, don't wait for your routine checkup. Contact your provider to have a screening as soon as possible.

Symptoms of postpartum depression include:

• Feeling sad or empty most of the time
• Eating too much or too little
• Sleeping too much or too little
• Crying a lot
• Feeling angry
• Pulling away from family and friends
• Worrying or feeling anxious
• Not having any interest in your baby
• Constant doubts about your ability to care for your baby
• Thinking about hurting yourself or your baby

If you have thoughts about suicide, or hurting yourself or your baby get help right away:

• Call 911 or go to your local emergency room
• Contact a crisis hotline. In the United States, you can reach the National Suicide and Crisis Lifeline at any time:
  • Call or text 988
  • Chat online with Lifeline Chat
  • TTY users: Use your preferred relay service or dial 711 then 988
• Veterans can contact the Veterans Crisis Line:
  • Call 988 then press 1
  • Text 838255
  • Chat online
• Call your mental health provider or other provider
• Reach out to a loved one or close friend

You may be more likely to develop depression after birth if you:

• Have had depression or bipolar disorder or a family health history that includes these conditions
• Don't have support from family or friends
• Had a multiple birth (twins, triplets, or more)
• Have a baby in your teens
• Had health problems in pregnancy
• Had a preterm labor or other birth problems
• Have a baby with special needs

What happens during a postpartum depression screening?

You may have a postpartum depression screening as part of a routine checkup after giving birth. Your baby's provider may also screen you for postpartum depression at your baby's routine well-infant visits.

During the screening you'll answer a set of questions. Your provider may ask the questions, or you may fill out a questionnaire form to discuss with your provider later. One of the most common questionnaires is called the Edinburgh Postnatal Depression Scale (EPDS). The EPDS includes 10 questions about your mood and thoughts.

Your provider may also order a blood test to find out if a physical condition, such as hyperthyroidism or hypothyroidism, may be causing your depression.

During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for a postpartum depression screening?

You usually don't need any special preparations for a postpartum depression screening.

Are there any risks to screening?

There is no risk to having a physical exam or taking a questionnaire.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your screening shows you may have postpartum depression, it's important to get treatment as soon as possible. You may need treatment from a mental health provider. A mental health provider is a health care professional who specializes in diagnosing and treating mental health problems.

Along with medicine and talk therapy, there are things you can do at home that may help you feel better, such as:

• Asking for help caring for the baby and doing other household chores
• Spending time with other adults
• Taking time for yourself
• Resting when the baby rests

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a postpartum depression screening?

You may have heard the terms "perinatal depression" and "peripartum depression." They both describe depression that happens either during pregnancy or just after birth. Research shows that depression during pregnancy increases your risk of postpartum depression. To help prevent postpartum depression, some medical experts recommend depression screening during routine pregnancy checkups.

A rare but more serious form of postpartum depression is called postpartum psychosis. Postpartum psychosis may cause hallucinations (seeing or hearing things that aren't real) and confusion. It is a medical emergency and it's important to get help immediately by calling 911 or going to the nearest emergency room.

References

1. ACOG: Women's Healthcare Physicians [Internet]. Washington D.C.: American College of Obstetricians and Gynecologists; c2022. Postpartum Depression; [updated 2021 Dec; cited 2022 Oct 26]; [about 6 screens]. Available from: https://www.acog.org/womens-health/faqs/postpartum-depression
2. American Academy of Pediatrics [Internet]. Elk Grove Village (IL): American Academy of Pediatrics; c2022. Patient Care: Integrating Postpartum Depression Screening into Your Practice in 4 Steps; [updated 2022 Jun 22;cited 2022 Oct 26]; [about 7 screens]. Available from: https://www.aap.org/en/patient-care/perinatal-mental-health-and-social-support/integrating-postpartum-depression-screening-in-your-practice-in-4-steps/
3. American Pregnancy Association [Internet]. Irving (TX): American Pregnancy Association; c. Do I Have The Baby Blues Or Postpartum Depression?; [cited 2022 Oct 26]; [about 8 screens]. Available from: https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/baby-blues-or-postpartum-depression/
4. American Psychiatric Association [Internet]. Washington D.C.: American Psychiatric Association; c2022. What Is Peripartum Depression (formerly Postpartum)?; [updated 2020 Oct; cited 2022 Oct 26]; [about 7 screens]. Available from: https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression
5. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Depression Among Women; [updated 2022 May 23; cited 2022 Oct 26]; [about 3 screens]. Available from: https://www.cdc.gov/reproductivehealth/depression
6. Eunice Kennedy Shriver National Institute of Child Health and Human Development [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; National Child & Maternal Health Education Program: Moms' Mental Health Matters; [reviewed 2022 Jun 2; cited 2022 Oct 26]; [about 10 screens]. Available from: https://www.nichd.nih.gov/ncmhep/initiatives/moms-mental-health-matters/moms
7. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; c2022. Health: Blood Test; [cited 2022 Oct 20]; [about 3 screens]. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/blood-test
8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2022. Healthy Lifestyle: Pregnancy week by week; [cited 2022 Oct 26]; [about 4 screens]. Available from: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-20237875
9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2022. Postpartum depression: Diagnosis and treatment; [cited 2022 Oct 26]; [about 7 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623
10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2022. Postpartum depression: Symptoms and causes; [cited 2022 Oct 26]; [about 8 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
11. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2022. Postpartum Depression; [revised 2022 Feb; cited 2022 Oct 26]; [about 5 screens]. Available from: https://www.merckmanuals.com/home/women-s-health-issues/postdelivery-period/postpartum-depression
12. Merck Manual Professional Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2022. Postpartum Depression; [revised 2022 Jan; cited 2022 Oct 26]; [about 3 screens]. Available from: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/postpartum-depression
13. Mughal S, Azhar Y, Siddiqui W. Postpartum Depression. [Updated 2022 Oct 7; cited 2022 Oct 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519070/
14. National Institute of Mental Health [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Perinatal Depression; [cited 2022 Oct 26]; [about 6 screens]. Available from: https://www.nimh.nih.gov/health/publications/perinatal-depression
15. Office on Women's Health [Internet]. Washington D.C.: U.S. Department of Health and Human Services; Postpartum depression; [updated 2021 Feb 17; cited 2022 Oct 26]; [about 5 screens]. Available from: https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression
16. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Postpartum Depression Risk Assessment; [cited 2022 Oct 26]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=42&contentid=PostpartumDepressionMRA
17. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2022. Health Information: Health Facts for You: Postpartum Depression; [updated 2018 Oct 10; cited 2022 Oct 26]; [about 4 screens]. Available from: https://patient.uwhealth.org/healthfacts/5112

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Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019