CMS study shows increase in ICD-10-CM code utilization for social determinants of health

Healthcare providers are using ICD-10-CM Z codes at an increasing rate to document social determinants of health (SDoH), according to a new report from CMS.

The report reviews data from 2017, when Z codes were used for 467,136 Medicare fee-for-service beneficiaries. That figure represents a 5% increase in Z code utilization from 2016, according to CMS.

The most frequent codes used in 2017 were Z59.0 to document homelessness (223,062 claims), Z60.2 to document problems related to living alone (196,551 claims), Z63.4 to account for the disappearance and death of a family member (127,766 claims), Z65.8 to capture other specified problems related to psychosocial circumstances (58,083 claims), and Z63.0 to make note of problems in relationships with a spouse or partner (49,448 claims).

CMS introduced Z codes with the implementation of ICD-10-CM in 2015, expanding them in 2016 to capture more SDoH. The implementation of Z codes enables healthcare providers to document the factors that contribute to a patient’s status. As the CMS report notes, “SDoH data collection can lead to an increase in patient referrals to supportive services and help identify population-level trends that have both health and cost implications.”

For more information on using Z codes, see the American Hospital Association’s new resource on ICD-10-CM Coding for Social Determinants of Health.

To learn more about SDoH, including how to code for them, see HCPro’s The Social Determinants of Health: Case Management’s Next Frontier from Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP.