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v1.0.0
ICD-10 Guide
ICD-10 CodesZ13.42

Z13.42

Encounter for screening for global developmental delays (milestones)

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

Code Description

ICD-10 Z13.42 is a billable code used to indicate a diagnosis of encounter for screening for global developmental delays (milestones).

Key Diagnostic Point:

Z13.42 is used to indicate an encounter for screening for global developmental delays, particularly in assessing a child's developmental milestones. This screening is crucial in identifying potential delays in areas such as motor skills, language, and social-emotional development. Factors influencing health status include socioeconomic status, access to healthcare, and parental education levels, which can significantly impact a child's development. Preventive care through early screening can lead to timely interventions, improving long-term outcomes. Social determinants of health, such as family dynamics, community resources, and environmental factors, play a vital role in a child's development and should be considered during the screening process. This code is essential for tracking and addressing developmental concerns early, ensuring children receive appropriate support and resources.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for comprehensive documentation of developmental milestones assessed
  • Variability in screening tools and methods used across practices
  • Potential overlap with other developmental codes requiring careful differentiation
  • Influence of social determinants on developmental outcomes that must be documented

Audit Risk Factors

  • Inadequate documentation of screening results
  • Failure to link the Z code to a specific encounter or reason for visit
  • Misuse of the code when developmental delays are already diagnosed
  • Lack of follow-up documentation for identified delays

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document the specific developmental milestones assessed, results of the screening, and any referrals made for further evaluation.

Common Clinical Scenarios

Routine well-child visits where developmental milestones are assessed, and referrals to specialists are made if delays are identified.

Billing Considerations

Consideration of family history, socioeconomic factors, and access to resources that may affect developmental outcomes.

Public Health

Documentation Requirements

Population-level data collection on screening rates and outcomes, including demographic information to assess health disparities.

Common Clinical Scenarios

Community health initiatives aimed at increasing awareness and access to developmental screenings.

Billing Considerations

Focus on tracking health status trends and implementing programs to address identified gaps in developmental health.

Coding Guidelines

Inclusion Criteria

Use Z13.42 When
  • Z codes are used when a patient is not currently ill but requires screening or preventive services
  • 42 should be sequenced appropriately, often as a primary diagnosis when the encounter is solely for screening
  • Payer requirements may vary, so it's essential to verify coverage for developmental screenings

Exclusion Criteria

Do NOT use Z13.42 When
No specific exclusions found.

Related CPT Codes

96110CPT Code

Developmental screening, with interpretation and report

Clinical Scenario

Used during well-child visits when developmental milestones are assessed.

Documentation Requirements

Document the specific screening tools used and results.

Specialty Considerations

Primary care providers should ensure comprehensive assessments are performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding developmental screenings, enabling better tracking of health outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding developmental screenings, enabling better tracking of health outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding developmental screenings, enabling better tracking of health outcomes and resource allocation.

Resources

Clinical References

  • •
    CDC Developmental Milestones

Coding & Billing References

  • •
    CDC Developmental Milestones

Frequently Asked Questions

When should Z13.42 be used?

Z13.42 should be used during encounters specifically for screening developmental milestones, particularly when there are concerns about delays. It is essential to document the specific milestones assessed and any referrals made.