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v1.0.0
ICD-10 Guide
ICD-10 CodesZ13.41

Z13.41

Encounter for autism screening

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 Z13.41 is a billable code used to indicate a diagnosis of encounter for autism screening.

Key Diagnostic Point:

Z13.41 is used to indicate an encounter for screening for autism spectrum disorder (ASD). This screening is crucial for early identification and intervention, which can significantly improve developmental outcomes for children. Factors influencing health status include genetic predispositions, environmental factors, and social determinants such as access to healthcare, socioeconomic status, and parental education levels. Preventive care through routine screenings allows for timely referrals to specialists and tailored interventions. The code is applicable in various settings, including primary care, where pediatricians routinely screen children during well-child visits, and in public health initiatives aimed at monitoring and improving community health outcomes. Documentation must reflect the purpose of the visit, the screening tools used, and any follow-up actions taken based on the results.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of screening tools used
  • Variability in screening guidelines across age groups
  • Potential for co-occurring conditions that may complicate coding
  • Requirement for follow-up documentation if screening indicates further evaluation

Audit Risk Factors

  • Inadequate documentation of screening tools and results
  • Failure to document follow-up actions or referrals
  • Coding without a clear indication of the screening purpose
  • Misuse of the code when the encounter is for a different purpose

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Documentation must include the reason for the screening, tools used, and results. Any referrals or follow-up plans should also be noted.

Common Clinical Scenarios

Routine well-child visits where autism screening is performed, follow-up visits for children flagged during initial screenings.

Billing Considerations

Consideration of social determinants such as family history of autism, access to early intervention services, and parental education.

Public Health

Documentation Requirements

Documentation should include population-level data, screening rates, and outcomes to assess community health initiatives.

Common Clinical Scenarios

Community health screenings, epidemiological studies assessing autism prevalence.

Billing Considerations

Focus on tracking health disparities and access to screening services across different populations.

Coding Guidelines

Inclusion Criteria

Use Z13.41 When
  • Z codes are used to indicate encounters for reasons other than illness or injury
  • 41 should be sequenced as a primary diagnosis when the encounter is solely for screening
  • Payer requirements may vary, so it is essential to verify coverage for autism screenings

Exclusion Criteria

Do NOT use Z13.41 When
No specific exclusions found.

Related CPT Codes

96110CPT Code

Developmental screening, with interpretation and report

Clinical Scenario

Used during well-child visits when autism screening is performed.

Documentation Requirements

Documentation must include the screening tool used and results.

Specialty Considerations

Primary care providers should ensure that screenings are age-appropriate and follow recommended guidelines.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding encounters for autism screening, improving data collection and analysis for public health initiatives.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding encounters for autism screening, improving data collection and analysis for public health initiatives.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding encounters for autism screening, improving data collection and analysis for public health initiatives.

Resources

Clinical References

  • •
    CDC Autism Spectrum Disorder (ASD) Screening

Coding & Billing References

  • •
    CDC Autism Spectrum Disorder (ASD) Screening

Frequently Asked Questions

When should Z13.41 be used?

Z13.41 should be used when a patient encounter is specifically for autism screening, typically during routine well-child visits or when concerns about developmental delays are raised.