The buzz about social determinants of health (SDOH) has been making the rounds for several years now as experts understand more about how the environments in which people live affect their health and quality-of-life risks and outcomes. Healthy People 2030 is a government initiative to improve the health and well-being of the US population over the next decade. It includes 355 measurable objectives along with developmental and research objectives.
According to health.gov, SDOH can be divided into 5 domains:
Our coded data plays a great role in this initiative by providing measurable data. To strengthen reporting of SDOH, the ICD-10-CM Official Guidelines for Coding and Reporting (OCG) have been expanded for fiscal year 2022 (effective October 1, 2021). New OCG I.C.21.c.17. states that SDOH should be reported when the information is documented, and that this information may be obtained from the following documentation sources:
- The patient’s provider (e.g., physician, nurse practitioner)
- Clinicians other than the patient’s provider whose documentation is included in the official medical record (e.g., social workers, community health workers, case managers, nurses)
- Patient self-reported documentation, as long as the documentation is signed-off by an incorporated into the medical record by either a clinician or a provider
Most SDOH codes are found in categories Z55-Z65:
- Z55, Problems related to education and literacy
- Z56, Problems related to employment and unemployment
- Z57, Occupational exposure to risk factors
- Z58, Problems related to physical environment
- Z59, Problems related to housing and economic circumstances
- Z60, Problems related to social environment
- Z62, Problems related to upbringing
- Z63, Other problems related to primary support group, including family circumstances
- Z64, Problems related to certain psychosocial circumstances
- Z65, Problems related to other psychosocial circumstances
With this government initiative and new coding guideline, Haugen Consulting Group recommends adopting a policy for coding SDOH on every patient, if your facility doesn’t have one already.
Want to learn more about the upcoming code changes? Tune into the following webinars this month to get the lowdown!
- August 19: New ICD-10-PCS procedure codes
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from https://health.gov/healthypeople/objectives-and-data/social-determinants-health
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.