Q&A: CPT reporting for a depression screening performed during a routine OB visit

Q: A patient presents for routine obstetrical (OB) care following a vaginal delivery. During the visit, the provider performs a postpartum depression screening. Should the depression screening be charged separately from the global OB visit service?  

A: If the physician reports a global obstetrical CPT code, the payer will most likely consider the screening as part of the global service. This is particularly true if the physician routinely screens every OB patient for depression. However, some payers offer additional reimbursement for depression screenings reported separately and in addition to a global OB visit service. Coders should check with payers on their policies for this.

If the physician diagnoses the patient with depression, the coder would always report this separately, since the global pregnancy package is valued for uncomplicated antepartum, delivery, and postpartum care. Coders should also be aware that some payers only reimburse psychologists and psychiatrists for depression treatments.

Notably, the CPT Manual identifies the global OB codes as:

• 59400, routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care
• 59510, …; cesarean delivery and postpartum care
• 59610, …; vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery
• 59618, …; cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery

Coders may report postpartum depression using ICD-10-CM code F53.0 (postpartum depression).

Editor’s note: Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, ICD-10-CM/PCS ambassador/trainer and an E/M, and procedure-based coding, compliance, data charge entry and HIPAA privacy specialist in Melba, Idaho answered this question during the HCPro webinar, 2020 ICD-10-CM/CPT Reporting for Obstetrical Services. She can be reached at webbservices.lori@gmail.com or http://lori-lynnescodingcoachblog.blogspot.com/.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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