Codes Z55-Z65 Social Determinants of Health

May 29, 2020 | Uncategorized

This week’s code spotlight highlights the social determinants of health codes that deal with many factors including prescribed medications or a patient’s BMI. Read below for more information on some of the benefits of including social determinants of health in reporting.nnAs the health care industry sees an increase of risk adjustment coding, the importance of correct and accurate ICD-10 coding is continuing to be an area of discussion among the various organizations. Although these codes do not carry an HCC level, from a correct coding standpoint, it is always important to code to the greatest specificity supported by the documentation. Social determinants of health (SDoH) category codes of Z55-Z65 are part of Chapter 21 [Factors Influencing Health Status and Contact with Health Services] which all deal with a wide range of factors from prescribed medications to a patients BMI. As coders, it’s important to not forget to report these codes if they are supported by the documentation. As clinicians, it is important to make sure that these factors are documented when present.nnIn a November 2019 article posted on the American Medical Associations website ( some of the benefits of including SDoH in their reporting include:n


  • Track the social needs that impact their patients, allowing for personalized care that addresses patients medical and social needs
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  • Aggregate data across patients to determine how to focus on a social determinants strategy
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  • Identify population health trends and guide community partnerships
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nFor hospitals, this is not a new concept. They have social workers on staff who typically are charged with documentation of these factors. This is why independent practices and outpatient services can begin doing a better job to capture these data points, and making sure our clinical staff are including these important factors in their documentation.nnClick here to read more on the social determinants of health.