Coding Corner: ICD-10 Codes for Social Determinants of Health | Karin Shih, MD, FACOG, FACS

Over recent years, there has been an increase in the volume and specificity of ICD-10 codes. This allows for a more complete documentation to capture the complexity of patient care provided. The rationale for these changes is the transition from fee-for-service to a value-based care healthcare model as well as an emphasis on quality of care.

The 2023 ICD-10-CM updates include 1,176 new codes, 28 revised, and 287 deleted codes that became effective October 1, 2022. Over the next few “Coding Corners,” we will specifically address several changes that are applicable to gynecologic oncology practice.

The first change that we will address in this issue is the addition of social determinants of health codes. In addition to clinical care, social determinants of health (SDOH) have a large impact on patient outcomes, and we now have a way to incorporate how SDOH impact the complexity of care in gynecologic oncology. It is recommended to assign as many SDOH codes to describe all of the risk factors. The documentation in the medical record should support the SDOH code as an impact on the E/M coding. For example, Z60.2 (problems related to living alone) should only be used if it results in a significant impact on the coordination of care. There are also three new ICD-10 codes added to category Z55-65 (persons with potential health hazards related to socioeconomic and psychosocial circumstances). These include Z59.82 (transportation insecurity), Z59.86 (financial security), and Z59.87 (material hardship). Documentation of SDOH will help capture data to address and improve health care overall.

Karin Shih, MD, FACOG, FACS, is a gynecologic oncologist at Hofstra Northwell School of Medicine in New Hyde Park, NY.