Identifying Social Determinants of Health, Coding, and HIPAA

What Are Social Determinants of Health?

To put it briefly, social determinants of health are the ways that the conditions in which people live affect their health. They might include such factors as transportation, housing, education, or social isolation which can influence health status. These influences are important for healthcare professionals to consider because addressing them is a key part of achieving health equity.

Minority groups, in particular, tend to be disproportionately affected by social determinants of health. There are a number of ways that healthcare providers are beginning to incorporate social determinants of health into patient care.

Example Z Codes in ICD-10-CM

In some situations, a clinician may decide to make a note of a patient’s socioeconomic and psychosocial needs. If this happens, there is a group of codes within ICD-10 that can help record this information – Z codes. Some examples of these Z codes include:

  • Z56: Problems related to employment and unemployment
  • Z58: Problems related to physical environment
  • Z59: Problems related to housing and economic circumstances
  • Z60: Problems related to social environment

The Centers for Medicare and Medicaid Services (CMS) is also conducting tests to determine whether finding and dealing with the health-related social needs of Medicare and Medicaid beneficiaries can improve their health outcomes or affect their healthcare costs. One of the ways they are examining this potential difference is by asking providers to use the Accountable Health Communities (AHC) Health-Related Social Needs Screening Tool. This tool focuses on five core areas:

  • Housing instability
  • Food insecurity
  • Transportation problems
  • Utility help needs
  • Interpersonal safety

This screening tool also includes eight supplemental domains covering topics such as financial strain, family and community support, education, and mental health. It is important to note that the AHC Health-Related Social Needs Screening Tool is not yet standard practice nationwide. It is primarily being used as a way to increase awareness of social determinants of health. However, it is a standard tool for the communities that are participating in the AHC Model.

Are Social Determinants Of Health Data Protected Under HIPAA?

Once your organization has collected data about social determinants of health that are potentially influencing a patient, what steps should you take to keep this information secure and protected? Before answering this question, you should first identify whether any of this information might be protected under HIPAA.

  • Read the Entire Article, Get Links to Screening Tool and more – Click Here
  • Learn Medical Coding – Click Here

From the American Institute for Healthcare Compliance, November 11, 2019