22-195m Help Tailor Services and Programs for At-Risk Members with New Social Determinants of Health Codes
Date: 02/28/22
Use the diagnosis codes on your claims or encounters to capture reliable data as it relates to your patients
The Department of Health Care Services’ social determinants of health (SDOH) codes have been expanded from 18 to 25 priority codes and are listed below.1 The codes were effective February 3, 2022, and based on the ICD-10-CM.2
The codes were added to help close the gap in identifying health disparities and their root causes. The aim is to better plan and coordinate care as well as give personalized care to your patients.
Be part of the CalAIM’s Population Health Management initiative
Your support in providing SDOH data is vital to the success of the California Advancing and Innovating Medi-Cal (CalAIM) Population Health Management (PHM) initiative. CalAIM’s PHM initiative identifies and manages member risk and need through whole-person care approaches while focusing on and addressing SDOH.
DHCS Priority SDOH Codes – changes are in italics
Code | Description |
|---|---|
Z55.0 | Illiteracy and low-level literacy |
Z58.6 | Inadequate drinking water supply |
Z59.00 | Homelessness unspecified |
Z59.01 | Sheltered homelessness |
Z59.02 | Unsheltered homelessness |
Z59.1 | Inadequate housing (lack of heating/space, unsatisfactory surroundings) |
Z59.3 | Problems related to living in residential institution |
Z59.41 | Food insecurity |
Z59.48 | Other specified lack of adequate food |
Z59.7 | Insufficient social insurance and welfare support |
Z59.811 | Housing instability, housed, with risk of homelessness |
Z59.812 | Housing instability, housed, homelessness in past 12 months |
Z59.819 | Housing instability, housed, unspecified |
Z59.89 | Other problems related to housing and economic circumstances |
Z60.2 | Problems related to living alone |
Z60.4 | Social exclusion and rejection (physical appearance, illness or behavior) |
Z62.819 | Personal history of unspecified abuse in childhood |
Z63.0 | Problems in relationship with spouse or partner |
Z63.4 | Disappearance and death of family member (assumed death, bereavement) |
Z63.5 | Disruption of family by separation and divorce (marital estrangement) |
Z63.6 | Dependent relative needing care at home |
Z63.72 | Alcoholism and drug addiction in family |
Z65.1 | Imprisonment and other incarceration |
Z65.2 | Problems related to release from prison |
Z65.8 | Other specified problems related to psychosocial circumstances (religious or spiritual problem) |
Additional information
If you have questions regarding the information contained in this update, contact CHWP at 877-658-0305.
1 All Plan Letter 21-009 (revised), Collecting Social Determinants of Health Data, dated February 3, 2022
2 ICD-10-CM – International Classification of Diseases, Tenth Edition, Clinical Modification