eHealth Initiative Releases Tools to Promote ICD-10 Codes for SDOH Data

Oct. 22, 2019

The eHealth Initiative & Foundation (eHI) has released a set of tools designed to help promote the use of ICD-10-CM Z codes to capture social determinants of health (SDOH) data.

Z codes are a special group of codes provided in ICD-10-CM for the reporting of factors influencing health status and contact with health services.

This collaborative project, consisting of industry leaders from payer organizations and other stakeholder groups, sought to develop a consistent and unified approach to promote the use of existing ICD-10-CM codes for SDOH and the adoption and utilization of proposed SDOH codes, once approved, among provider organizations and coding professionals.

Organizations in the collaborative include Humana, UnitedHealthcare, the American Hospital Association, and others.

eHI officials contend that SDOH data captures information at a level traditional health data sources cannot. “By integrating SDOH insights into care plans, healthcare stakeholders can recognize the need for, and enable access to, additional services or interventions for patients,” said Jennifer Covich Bordenick, CEO, eHealth Initiative & Foundation. “ICD-10-CM Z codes can be used to record this information, directly into patient records, offering deeper insights into factors such as reliable housing, healthy food, and transportation, which also affect health.”

UnitedHealthcare, in fact, has done work prior work in this area, having implemented a program that’s incorporating social determinants of health data into clinician workflow processes in order to improve care management and enhance plan members’ health. That project was detailed here as part of the 2019 Innovator Awards program.

Nelly Leon-Chisen, director, coding and classification, American Hospital Association, noted, “Using the Z codes for social determinants of health helps hospitals and health systems to better track patient needs and identify solutions to improve the health of their communities. The use of SDOH data from the electronic health record (EHR) for clinical, operational, and research purposes can facilitate tracking, identification, and referrals to social and governmental services. To assign ICD-10-CM codes for social determinants of health, coding professionals may use documentation from a physician or any other person authorized to document in the patient’s medical record, such as a nurse or social worker.”

Added Caraline Coats, Humana’s Vice-President of Bold Goal & Population Health Strategy, “Social-needs gaps – such as isolation, loneliness and food insecurity—make it hard to have a happy, healthy, purposeful life, and that has a tremendous impact on overall well-being, “Standardized screening and code capturing can reveal these upstream impacts on health and create richer data that helps physicians, care managers, social workers and home health professionals meet our members’ needs more proactively. The result is better care and better health outcomes at a lower cost.”

The ICD-10-CM Z codes tools were launched in conjunction with a webinar featuring panelists from participating stakeholder organizations. All four tools are available on eHI's website.

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