Z34.90 - Encounter for supervision of normal pregnancy, unspecified trimester

Clinical Definition

Coding of depression episodes where a concurrent schizophrenic disorder is present. This code accurately captures the dual presence of both mental health conditions, acknowledging their co-occurrence and interaction.

Documentation Requirements

• Must explicitly document both conditions:

  • Active schizophrenia diagnosis with current symptoms

  • Current depressive episode severity

• Temporal relationship must be clear

• Document evidence of:

  • Depressive symptoms (mood, sleep, appetite changes)

  • Schizophrenic features (delusions, hallucinations)

• Specify if:

  • Treatment response

  • Current medications

  • Impact on function

Common Synonyms

• Post-psychotic depression

• Schizoaffective depression

• Depressed mood in schizophrenia

• Mixed schizophrenia and depression

Coding Conflicts

Excludes1:

• Schizoaffective disorder, depressive type (F25.1)

• Cycloid psychosis with symptoms of depression (F23)

Note: Cannot be coded with standalone major depressive disorder codes.

Scribing.io Automation

The AI scribe automatically:

1. Identifies key phrases indicating both conditions ("schizophrenia with depression")

2. Maps temporal relationships between symptoms

3. Extracts severity indicators for both conditions

4. Tags mood symptoms separate from psychotic features

5. Alerts provider if documentation is insufficient for dual diagnosis coding