New Codes Relating to Social Factors Proposed


Social determinants of health—the conditions in which people are born, grow, work, live, and age, as well as the forces and systems shaping the conditions of their daily lives—are well known to impact health risks and outcomes. Because of this, the American Medical Association and UnitedHealthcare have teamed up in an effort to support the creation of twenty new ICD-10 codes related to social determinants.

The proposed codes aim to more effectively address non-medical issues that influence patient health, such as financial hardships, unemployment, and housing insufficiency.

In full, the proposed codes are:

  • Z55.5 Less than a high school degree
  • Z55.6 High school diploma or GED
  • Z56.83 Unemployed and seeking work
  • Z56.84 Unemployed but not seeking work
  • Z56.85 Employed part time or temporary
  • Z59.61 Unable to pay for prescriptions
  • Z59.62 Unable to pay for utilities
  • Z59.63 Unable to pay for medical care
  • Z59.64 Unable to pay for transportation for medical appointments or prescriptions
  • Z59.65 Unable to pay for phone
  • Z59.66 Unable to pay for adequate clothing
  • Z59.67 Unable to find or pay for child care
  • Z59.69 Unable to pay for other needed items
  • Z59.91 Worried about losing housing
  • Z60.81 Unable to deal with stress
  • Z60.82 Inadequate social interaction – limited to once or twice a week
  • Z60.83 Can hardly ever count on family and friends in times of trouble
  • Z60.84 Feeling unsafe in current location
  • Z60.85 Stressed quite a bit or very much
  • Z60.86 Stressed somewhat

The codes have been submitted to the ICD-10 Coordination and Maintenance Committee for consideration, and if approved, the would apply starting on October 1, 2020.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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