QUESTION: Our clinic is seeing more and more people who lack adequate food and housing. Sometimes this impacts the physician’s plan and assessments. The physicians are concerned that there is high risk for the patient not being able to carry out the needed health requirements. Is there any way for us to give the physicians additional credit for this work?
Question from Fresno, CA subscriber
ANSWER: The Evaluation and Management (E/M) changes for new 2021 office visit coding guidelines will allow you to factor Social Determinants of Health (SDH) in medical decision-making effective January 1. Potential health hazards such as inadequate housing (Z59.1) and food and safe drinking water (Z59.4) that are related to socioeconomic and psychosocial circumstances can be coded from the treating physician’s documentation. You can also count documentation from a physician who is not treating the patient for the factor but is considering it in the provider’s treatment and assessment.
There are a list of ICD-10-CM Z codes that describe SDH. Never report these as primary diagnoses and instead as secondary or additional diagnoses. Some additional codes for hazards your physician may be weighing in an encounter;s medical decision making are:
- Z55.0 – Illiteracy and low-level literacy
- Z59.0 – Homelessness
- Z59.5 – Extreme poverty
- Z59.7 – Insufficient social insurance and welfare support
- Z62.0 – Inadequate parental supervision and control.
For more 2021 E/M coding changes tactics, nationally recognized coding and training expert, Leonta Williams, RHIA, CCS, CCDS, CPC, CPCO, CRC, CEMC, CHONC, can help. During her upcoming online training “Master Massive E/M Coding Changes (99201-99215) by Jan. 1 Deadline,” Lee will walk you through EXACTLY how you can ethically and optimally apply every 2021 office visit code change by the January 1st deadline.
