CMS updates SDoH infographic

Oct. 9, 2023 / By Michelle Badore

Following the latest social determinants of health (SDoH) rules released early August, the Centers for Medicare & Medicaid Services (CMS) recently released an updated infographic on the importance of data collection for social determinants. 

This two-page document includes a flowsheet guiding organizations through setting the foundation by using ICD-10 Z codes with the range of Z55-Z65. Collecting SDoH can improve equity in health care delivery and research by: 

• Empowering providers to identify and address health disparities (e.g., care coordination and referrals) 
• Supporting quality measurement 
• Supporting planning and implementation of social needs interventions 
• Identifying community and population needs 
• Monitoring SDoH intervention effectiveness for patient outcomes 
• Utilizing data to advocate for updating and creating new policies 

The next page lists recent Z code categories and new codes, including the new codes that were issued in August (though the exhibit shows Z59.0 – Homelessness has been updated). However, the infographic did not include the Medicare policy change that three of these codes are now risk adjusted for Medicare Severity Diagnosis Related Groups (MS-DRGs) with inclusion and weighting as a comorbidity/complication or “cc.”     

While we continue to expect marked changes in this domain and the addition of more CCs to be released, we face the next conundrum: With proper documentation, a multitude of quality measures, patient safety indictors, hospital acquired conditions and socioeconomic codes being captured, how does an organization choose the top 25 on the bill? I would love to see the limitation of the current UB-04 form for data collection updated by the National Uniform Billing Committee (NUBC). In the meantime, using technology can help coders prioritize when there are more than 25 codes in the record. Please comment below if you have questions!   

Michelle Badore, global clinical and nosology content manager at 3M Health Information Systems.