New Baby Well Visits – Guidelines Related to Maternal Depression Screening
The maternal depression screening is for the benefit of the child even though the screening is focused on the mother. If your pediatric practice would like to complete maternal depression screenings, identify the approach of the practice – either an initial maternal depression screening at 1 month or multiple screenings (e.g. 4 maternal screenings within the first 9 months of the baby’s life). This is a medical discussion that pediatricians and pediatric providers need to decide first.
It is usually acceptable, from a payers perspective, to complete up to four maternal depression screenings in the first 9 months of a child’s life. A practice should adopt an approach/policy for managing maternal depression screening and follow this consistently. For each mother a pediatric provider completes the screening for, they should document in the chart “Maternal depression screening of mother completed” and note any findings of the screening. If the practice had the mother complete a screening tool (e.g. one page Edinburgh Postnatal Depression Scale), then a person from the practice can scan this completed form into the scanned documents of the baby for future reference. If possible, we recommend completing both of these documentation steps.
A commonly accepted maternal depression screening tool is the Edinburgh Postnatal Depression Scale (EPDS). This scoring instrument is 10 questions (one page) where the mother selects how she feels. If using this scoring tool, a score above 13 is considered to be suffering from depressive illness. Note that the score should not override clinical judgement. While this scoring tool is commonly available, please feel free to contact your account manager if you would like a copy of this scoring tool.
The maternal depression screening can usually be completed up to 8 months of age for the child (payers have different reimbursement policies – for example , up to four or only the initial). Many Medicaid programs that adopt an EPSDT program recommend this depression screening for the mother for up to four well visits: 1 well month, 2-3 month well visit, 4-5 month well visit, and 6-8 month well visit. Check with your account manager with questions related to reimbursement for the specific payers in your practice. The maternal depression screening CPT code is 96161.
If your practice is already performing this maternal depression screening routinely, you can request your account manager to have this code auto-linked to specific well visit templates (e.g. 1 month well visit). If using this auto add of the code, the providers need to remove the CPT code if the maternal depression screening was not completed.
The importance of these Maternal Depression Screening is vital to not just the health of the mother, but the baby as well. And as a pediatric practice, it is part of the practice mission to make sure that the well-being of the child is taken care of.