The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is implementing new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting effective April 1, 2023. These new codes will better enable the collection of health-related social needs (HRSNs), defined as individual-level, adverse social conditions that negatively impact a person’s health or healthcare, are significant risk factors associated with worse health outcomes as well as increased healthcare utilization. This 2023 ICD-10-CM Update is Effective April 1, 2023.
Chapter 19 – 4 New Codes
| Code | Description |
| T74.A1 | Adult financial abuse, confirmed |
| T74.A2 | Child financial abuse, confirmed |
| T76.A1 | Adult financial abuse, suspected |
| T76.A2 | Child financial abuse, suspected |
Chapter 20 – 15 New Codes
| Code | Description |
| Y07.010 | Husband, current, perpetrator of maltreatment and neglect |
| Y07.011 | Husband, former, perpetrator of maltreatment and neglect |
| Y07.020 | Wife, current, perpetrator of maltreatment and neglect |
| Y07.021 | Wife, former, perpetrator of maltreatment and neglect |
| Y07.030 | Male partner, current, perpetrator of maltreatment and neglect |
| Y07.031 | Male partner, former, perpetrator of maltreatment and neglect |
| Y07.040 | Female partner, current, perpetrator of maltreatment and neglect |
| Y07.041 | Female partner, former, perpetrator of maltreatment and neglect |
| Y07.050 | Non-binary partner, current, perpetrator of maltreatment and neglect |
| Y07.051 | Non-binary partner, former, perpetrator of maltreatment and neglect |
| Y07.44 | Child, perpetrator of maltreatment and neglect |
| Y07.45 | Grandchild, perpetrator of maltreatment and neglect |
| Y07.46 | Grandparent, perpetrator of maltreatment and neglect |
| Y07.47 | Parental sibling, perpetrator of maltreatment and neglect |
| Y07.54 | Acquaintance or friend, perpetrator of maltreatment and neglect |
Chapter 21 15 New Codes
| Code | Description |
| Z55.6 | Problems related to health literacy |
| Z58.81 | Basic services unavailable in physical environment |
| Z58.89 | Other problems related to physical environment |
| Z59.10 | Inadequate housing, unspecified |
| Z59.11 | Inadequate housing environmental temperature |
| Z59.12 | Inadequate housing utilities |
| Z59.19 | Other inadequate housing |
| Z62.814 | Personal history of child financial abuse |
| Z62.815 | Personal history of intimate partner abuse in childhood |
| Z91.141 | Patient’s other noncompliance with medication regimen due to financial hardship |
| Z91.148 | Patient’s other noncompliance with medication regimen for other reason |
| Z91.151 | Patient’s noncompliance with renal dialysis due to financial hardship |
| Z91.158 | Patient’s noncompliance with renal dialysis for other reason |
| Z91.413 | Personal history of adult financial abuse |
| Z91.414 | Personal history of adult intimate partner abuse |
Social needs data is critical to hospitals’ efforts to improve the health of their patients and communities. Recent and ongoing expansion of the ICD-10-CM code set allows for additional granularity when capturing these historically under reported environmental and social factors impacting a person’s health and wellness. Coding managers need to be developing or expanding coding guidelines for social determinants of health codes (Z55-Z65) to ensure consistent and accurate data collection. Education and follow-up auditing should also be performed. Be sure your education and guidelines incorporate the October 2022 updated coding guideline for Social Determinants of Health (SDOH) I.C.21.c.17) shown below.
Codes describing problems or risk factors related to social determinants of health (SDOH) should be assigned when this information is documented. Assign as many SDOH codes as are necessary to describe all of the problems or risk factors. These codes should be assigned only when the documentation specifies that the patient has an associated problem or risk factor. For example, not every individual living alone would be assigned code Z60.2, Problems related to living alone.
For social determinants of health, such as information found in categories Z55-Z65, Persons with potential health hazards related to socioeconomic and psychosocial circumstances, code assignment may be based on medical record documentation from clinicians involved in the care of the patient who are not the patient’s provider since this information represents social information, rather than medical diagnoses. For example, coding professionals may utilize documentation of social information from social workers, community health workers, case managers, or nurses, if their documentation is included in the official medical record. Patient self-reported documentation may be used to assign codes for social determinants of health, as long as the patient self-reported information is signed-off by and incorporated into the medical record by either a clinician or provider.
For more code updates, check out our blog.