Social Determinants of Health for Improved Outcomes

Social Determinants of Health (SDoH), socioeconomic and environmental factors that can impede or improve health, have always been a reality, but the trend of payers and providers factoring them into the impact on patients’ overall health is more recent.

Recently, the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) updated ICD-10-CM code set with 11 new diagnosis codes describing SDOH. The new Z codes were created to provide additional information regarding SDOH data such as housing, food insecurity, or transportation.

Addressing a patient’s health-related social needs can lead to better health outcomes and lower total health care costs. CarePartners of Connecticut encourages providers to use the specialized SDoH ICD-10 codes whenever possible, as they help to provide a more complete picture of the member. Below is a list of the new Z codes that have been added to the diagnosis classification:

Under category Z55 (Problems related to education and literacy)

  • 5 – Less than a high school diploma

Under category Z58 (Problems related to physical environment)

  • 6 – Inadequate drinking-water supply

Under category Z59 (Problems related to housing and economic circumstances)

  • 00 – Homelessness unspecified
  • 01 – Sheltered homelessness
  • 02 – Unsheltered homelessness
  • 41 – Food insecurity
  • 48 – Other specified lack of adequate food
  • 811 – Housing instability, housed, with risk of homelessness
  • 812 – Housing instability, housed, homelessness in past 12 months
  • 819 – Housing instability, housed unspecified
  • 89 – Other problems related to housing and economic circumstances

For more information, refer to this CMS article on SDoH.