2024 ICD-10-CM Diagnosis Code Z13.41

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:

• 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)

Z13.41 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

Z1341 replaces the following previously assigned ICD-10-CM code(s):

• Z13.4 - Encntr screen for certain developmental disorders in chldhd

Patient Education

Autism Spectrum Disorder (ASD) Screening

What is autism spectrum disorder screening?

Autism spectrum disorder (ASD) is a disorder of the brain that affects a person's behavior, communication, and social skills. The disorder usually shows up in the first two years of life. ASD is called a "spectrum" disorder because there is a wide range of symptoms. Autism symptoms can range from mild to severe. Some children with ASD may never be able to function without support from parents and caregivers. Others need less support and may eventually live independently.

ASD screening is the first step in diagnosing the disorder. While there is no cure for ASD, early treatment can help reduce autism symptoms and improve quality of life.

Other names: ASD screening

What is it used for?

Autism spectrum disorder screening is most often used to check for signs of autism spectrum disorder (ASD) in children aged 2 and under.

Why does my child need an autism spectrum disorder screening?

The American Academy of Pediatrics recommends that all children be screened for ASD at their 18-month and 24-month well-child checkups.

Your child may need screening at an earlier age if he or she has symptoms of ASD. Autism symptoms may include:

• Not making eye contact with others
• Not responding to a parent's smile or other gestures
• A delay in learning to talk. Some children may repeat words without understanding their meaning.
• Repeated body movements such as rocking, spinning, or flapping of hands
• Obsession with specific toys or objects
• Trouble with change in routine

Older children and adults may also need screening if they have autism symptoms and were not diagnosed as babies. These symptoms may include:

• Trouble communicating
• Feeling overwhelmed in social situations
• Repeated body movements
• Extreme interest in specific topics

What happens during an autism spectrum disorder screening?

There is no special test for ASD. Screening usually includes:

• A questionnaire for parents that asks for information about their child's development and behavior.
• Observation. Your child's provider will look at how your child plays and interacts with others.
• Tests that ask your child to perform tasks that check their thinking skills and ability to make decisions.

Sometimes a physical problem can cause autism-like symptoms. So screening may also include:

• Blood tests to check for lead poisoning and other disorders
• Hearing tests. A hearing problem can cause problems in language skills and social interaction.
• Genetic tests. These tests look for inherited disorders such as Fragile X syndrome. Fragile X causes intellectual disabilities and symptoms similar to ASD. It most often affects boys.

Will I need to do anything to prepare my child for an autism spectrum disorder screening?

There are no special preparations needed for this screening.

Are there any risks to a screening?

There is no risk to having an autism spectrum disorder screening.

What do the results mean?

If results show signs of ASD, your provider may refer you to specialists for more testing and/or treatment. These specialists may include a:

• Developmental pediatrician. A doctor who specializes in treating children with special needs.
• Neuropsychologist. A doctor who specializes in understanding the relationship between the brain and behavior.
• Child psychologist. A health care provider who specializes in treating mental health and behavioral, social, and development issues in children.

If your child is diagnosed with ASD, it's important to get treatment as soon as possible. Early treatment can help make the most of your child's strengths and abilities. Treatment has been shown to improve behavior, communication, and social skills.

ASD treatment involves services and support from a variety of providers and resources. If your child is diagnosed with ASD, talk to his or her provider about making a treatment strategy.

Is there anything else I need to know about autism spectrum disorder screening?

There is no one single cause of autism spectrum disorder. Research suggests that it is caused by a combination of factors. These may include genetic disorders, infections, or medicines taken during pregnancy, and an older age of one or both parents (35 or older for women, 40 or older for men).

Research also clearly shows that there is no link between childhood vaccines and autism spectrum disorder.

If you have questions about ASD risk factors and causes, talk to your child's health care provider.

References

1. Au AH, Shum KK, Cheng Y, Tse HM, Wong RM, Li J, Au TK. Autism spectrum disorder screening in preschools. Autism [Internet]. 2021 Feb; [cited 2021 Aug 3]; 25(2):516-528.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874379 
2. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Autism Spectrum Disorder (ASD): Screening and Diagnosis of Autism Spectrum Disorder; [cited 2019 Sep 26]; [about 4 screens]. Available from: https://www.cdc.gov/ncbddd/autism/screening.html
3. Durkin MS, Maenner MJ, Newschaffer CJ, Lee LC, Cunniff CM, Daniels JL, Kirby RS, Leavitt L, Miller L, Zahorodny W, Schieve LA. Advanced parental age and the risk of autism spectrum disorder. Am J Epidemiol [Internet]. 2008 Dec 1 [cited 2019 Oct 21]; 168(11):1268-76. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18945690
4. HealthyChildren.org [Internet]. Itasca (IL): American Academy of Pediatrics; c2019. Autism Spectrum Disorder: What is Autism Spectrum Disorder; [updated 2018 Apr 26; cited 2019 Sep 26]; [about 4 screens]. Available from: https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/Autism-Spectrum-Disorder.aspx
5. HealthyChildren.org [Internet]. Itasca (IL): American Academy of Pediatrics; c2019. How is Autism Diagnosed?; [updated 2015 Sep 4; cited 2019 Sep 26]; [about 4 screens]. Available from: https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/Diagnosing-Autism.aspx
6. HealthyChildren.org [Internet]. Itasca (IL): American Academy of Pediatrics; c2019. How Pediatricians Screen for Autism; [updated 2016 Feb 8; cited 2019 Sep 26]; [about 4 screens]. Available from: https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/How-Doctors-Screen-for-Autism.aspx
7. HealthyChildren.org [Internet]. Itasca (IL): American Academy of Pediatrics; c2019. What are the Early Signs of Autism?; [updated 2015 Sep 4; cited 2019 Sep 26]; [about 4 screens]. Available from: https://www.healthychildren.org/English/health-issues/conditions/Autism/Pages/Early-Signs-of-Autism-Spectrum-Disorders.aspx
8. Kids Health from Nemours [Internet]. Jacksonville (FL): The Nemours Foundation; c1995–2019. Autism Spectrum Disorder; [cited 2019 Sep 26]; [about 3 screens]. Available from: https://kidshealth.org/en/parents/pervasive-develop-disorders.html
9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Autism spectrum disorder: Diagnosis and treatment; 2018 Jan 6 [cited 2019 Sep 26]; [about 4 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2019. Autism spectrum disorder: Symptoms and causes; 2018 Jan 6 [cited 2019 Sep 26]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928
11. National Institute of Mental Health [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Autism Spectrum Disorder; [updated 2018 Mar; cited 2019 Sep 26]; [about 3 screens]. Available from: https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml
12. Pierce K, Gazestani V, Bacon E, Courchesne E, Cheng A, Barnes CC, Nalabolu S, Cha D, Arias S, Lopez L, Pham C, Gaines K, Gyurjyan G, Cook-Clark T, Karins K. Get SET Early to Identify and Treatment Refer Autism Spectrum Disorder at 1 Year and Discover Factors That Influence Early Diagnosis. J Pediatr [Internet]. 2021 Apr 27 [cited 2021 Aug 3]; S0022-3476(21): 00392-9. Available from: https://pubmed.ncbi.nlm.nih.gov/33915154 
13. Psychologist-License.com [Internet]. Psychologist-License.com; c2013–2019. Child Psychologists: What they do and how to become one; [cited 2019 Sep 26]; [about 3 screens]. Available from: https://www.psychologist-license.com/types-of-psychologists/child-psychologist.html#context/api/listings/prefilter
14. Research Gate [Internet]. ResearchGate GmbH; c2008-2021. Communication and Symbolic Behavior Scales Developmental Profile Infant/Toddler Checklist; 2001 Jan [cited 2021 Aug 3]; [about 2 screens]. Available from: https://www.researchgate.net/publication/252234671_Communication_and_Symbolic_Behavior_Scales_Developmental_Profile_InfantToddler_Checklist 
15. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Fragile X syndrome: Overview; [updated 2019 Sep 26; cited 2019 Sep 26]; [about 2 screens]. Available from: https://ufhealth.org/fragile-x-syndrome
16. UNC School of Medicine [Internet]. Chapel Hill (NC): University of North Carolina at Chapel Hill School of Medicine; c2018. Neuropsychological Evaluation FAQ; [cited 2019 Sep 26]; [about 4 screens]; Available from: https://www.med.unc.edu/neurology/divisions/movement-disorders/npsycheval
17. Kaiser Permanente [Internet]. Kaiser Foundation Health Plan of Washington; c2021. Autism Spectrum Disorder (ASD); [cited 2021 Aug 2]; [about 3 screens]. Available from: https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw152184 

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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