Accurate coding provides an opportunity to improve patient outcomes, public health and provide health equity for all individuals.
By: April Smith, CCS
The World Health Organization’s Constitution states that health is a state of “complete physical, mental and social well-being, not merely the absence of disease or infirmity,” and that, “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.”
Overall health is determined by genetics and behavior, certainly, but also income and social status, education, social support networks, and access to health services.
We know the importance of genetics and behaviors on overall health. But what is the importance of those other factors? The Kaiser Family Foundation documented that social factors accounted for over a third of total deaths in the United States in a year. They also resulted in added healthcare expenditures, loss of productivity and premature death.
Social Determinates of Health Captured through ICD-10-CM Codes
To assess these discrepancies in overall health, statistics regarding Social Determinants of Health must be collected and studied. To gather this information, new ICD-10-CM codes effective 10/1/2021 are found in Chapter 21, Categories Z55-Z65:
- Z55 Problems related to education/literacy
- Z56 Problems related to employment/unemployment
- Z57 Occupational exposure to risk factors
- Z58 Problems related to physical environment
- Z59 Problems related to housing/economic circumstances
- Z60 Problems related to social environment
- Z62 Problems related to upbringing
- Z63 Other problems related to primary support group/family circumstances
- Z64 Problems related to certain psychosocial circumstances
- Z65 Problems related to other psychosocial circumstances
Capturing and reporting the codes that capture Social Determinates of Health provide an opportunity to improve patient outcomes, public health and provide health equity for all individuals. HIM Professionals play a critical role in that opportunity to improve lives and health outcomes.
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