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Providers will soon have more ICD-10 codes to describe the nonclinical and social factors that can influence a patient’s health.
The Centers for Medicare and Medicaid Services (CMS) added nearly 400 new codes on October 1, with eight relating to social determinants of health (SDOH) for minors. The new 2024 codes, which are used to bill insurance, may help health systems use healthcare data to understand how a child’s home environment can affect health outcomes.
“These were created just to really report the family dynamics that extend beyond the traditional nuclear family that involves the child being in the care of a nonparental relative or a nonrelative caregiver,” Samantha Monahan, coding auditor and educator for consulting firm RuralMED Revenue Cycle Resources, said in a webinar last week.
New codes
Any clinician—including social workers, community health workers, or case managers—can record patient SDOH factors with these codes, which can help health systems standardize how they track and address the social needs of their patients and provide more personalized care, according to CMS.
The new SDOH-related ICD-10 codes, or “Z codes,” document situations like nonparental guardianship and conflicts in the living environment as well as whether a child lives in a group home or has run away, according to CMS.
A child’s living situation can affect their health as they grow.
For example, children who experienced food insecurity or housing instability, including living in overcrowded spaces or moving frequently, in early childhood had a higher risk of anxiety or depression during their teen years, a 2020 study from researchers at the University of Houston and the University of Texas Health Science Center found.
Children’s mental health was a top patient safety concern among care providers this year, Healthcare Brew previously reported.
Still, though more codes have been added to describe SDOH-related factors, providers may not be using them. In 2019, providers used Z codes for 1.6% of the nearly 63 million adults and children enrolled in fee-for-service Medicare, according to a CMS report.
“Coders may need encouragement and support from hospital leaders to collect these codes that were once perceived as a lower priority,” according to the report.