Using ICD-10 Z codes to track social drivers of health

Recognizing the influence of non-medical factors on overall health, it’s important for providers to screen patients for social drivers of health (SDOH). Also referred to as social determinants of health, these environmental conditions — such as where people are born, live, learn, work, worship, and age — can create barriers to treatment and have a profound effect on health disparities and equity. 

Given the impact of SDOH on a patient’s vulnerability to illness, access to health care, and ability to adhere to medical treatment, it’s crucial for care providers to identify and document SDOH as part of their daily practice — whether during patient registration, routine exams, or visits scheduled for a specific condition. As patients may not readily volunteer details about the social aspects of their lives, it’s essential to develop a process to gather this data, which is vital for connecting patients to community resources and follow-up services. 

To help CarePartners of Connecticut recognize members who are experiencing social problems or living with risk factors that could adversely affect their health, we encourage providers to include relevant ICD-10 Z codes when submitting claims for services. We’ve outlined the primary SDOH Z codes below. For a more comprehensive list of SDOH ICD-10 Z codes, please refer to our Social Drivers of Health Quick Reference Guide.

The following Z codes are used to document SDOH data, such as housing, food insecurity, and lack of transportation: 

  • Z55 - Problems related to education and literacy
  • Z56 - Problems related to employment and unemployment
  • Z57 - Occupational exposure to risk factors
  • Z59 - Problems related to housing and economic circumstances
    • Z59.0    Homelessness unspecified
    • Z59.1    Inadequate housing
    • Z59.41  Food insecurity
    • Z59.82  Transportation insecurity
    • Z59.86   Financial insecurity
  • Z60 - Problems related to social environment
  • Z62 - Problems related to upbringing
  • Z63 - Other problems related to primary support group, including family circumstances
  • Z64 - Problems related to certain psychosocial circumstances
  • Z65 - Problems related to other psychosocial circumstances
  • Z75 - Problems related to medical facilities and other health care

By identifying and addressing social drivers of health and helping patients understand their impact, providers can empower individuals to actively participate in their health care and take control of their well-being. To discuss concerns or make referrals for members with SDOH-related needs, call the CarePartners of Connecticut Provider Services team at 888-341-1508.

You can learn more about the importance of social drivers of health and health equity on the World Health Organization and Centers for Disease Control websites.