Come April 1, coders will have additional code options to further capture Social Determinants of Health (SDoH) as CDC released upcoming changes to both the code set and official guidelines on Jan. 9.
The new changes will include 42 code additions, seven deletions and one code revision. The additions were made to Chapters 19, 20 and 21 of the Tabular.
New SDoH code Z55 (Problems related to education and literacy) is among the code additions.
Also among the additions are codes to update category Y07 in order to better align verbiage related to critical perpetrator of abuse external cause codes with that of current CDC core data collection elements and literature related to patient maltreatment and neglect — including elder abuse.
For example, Y07.44 (Child (biological, step, in-law, foster, adopted), perpetrator of maltreatment, and neglect).
Some codes were also deleted to make more specific code options available. For instance, Z59.1 (Inadequate housing) is being deleted and replaced with code options:
- Z59.10 (Inadequate housing, unspecified)
- Z59.11 (Inadequate housing environmental temperature)
- Z59.12 (Inadequate housing utilities)
- Z59.19 (Other inadequate housing)
The one revision, made to Z59.87 (Material hardship), is an expansion of its description “Material hardship due to limited financial resources, NEC.”
Changes to the guidelines were also released including updated directions for assigning SDoH codes (See changes in bold):
“Social determinants of health (SDOH) codes describing social problems, conditions, or risk factors that influence a patient’s health should be assigned when this information is documented in the patient’s medical record. Assign as many SDOH codes as are necessary to describe all of the social problems, conditions, or risk factors documented during the current episode of care. For example, a patient who lives alone may suffer an acute injury temporarily impacting their ability to perform routine activities of daily living.
When documented as such, this would support assignment of code Z60.2 (Problems related to living alone). However, merely living alone, without documentation of a risk or unmet need for assistance at home, would not support assignment of code Z60.2. Documentation by a clinician (or patient-reported information that is signed off by a clinician) that the patient expressed concerns with access and availability of food would support assignment of code Z59.41 (Food insecurity). Similarly, medical record documentation indicating the patient is homeless would support assignment of a code from subcategory Z59.0-(Homelessness).”