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

References

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