Blue Review
A newsletter for contracting institutional and professional providers

March 2020

Use ICD-10 Z Codes to Document Social Determinants of Health Needs

To better track and address the social needs of our members, Blue Cross and Blue Shield of Illinois (BCBSIL) invites you to incorporate Social Determinants of Health (SDoH) ICD-10 Z codes on the claims you submit to us. Any clinician (physician, nurse, social worker, community health worker, case manager, or other providers) can document a person’s social needs.1

What are Social Determinants of Health?
Social determinants of health are conditions in the environments in which people are born, grow, live, work and age. These social factors can impose significant barriers to a person’s health and wellness.

Using Social Determinants of Health ICD-10 Codes
What does this mean for you and your staff? Each patient brings more to your office than the symptoms they present on the surface. SDoH may affect a patient’s ability or willingness to follow their recommended treatment plan, so it’s important to adopt a “whole-person” approach. By working together, we can help remove barriers to improved health and help provide an improved quality of life to members. Through the use of ICD-10 Z code data, we will be able to better understand the unique, social needs of BCBSIL members and help connect members with available resources.

What You Can Do:

  • Educate staff on the need to screen, document and code data on patients’ SDoH needs.
  • Ask patients about their SDoH needs. Patients may not know to discuss non-medical issues with their provider and may need to be prompted.
  • Document any SDoH needs by using the SDoH ICD-10 Z codes listed on this flyer and adding them to claims you submit to BCBSIL.

We would love to hear from you. Where are you in your health equity and social determinants of health journey? What challenges are you facing? What successes have you achieved? Your input will help us continue to enhance the Health Equity and Social Determinants of Health section of our Provider website with ways you can take action, along with helpful links and related resources. Please complete our brief survey now.

1American Hospital Association. ICD-10-CM Coding for Social Determinants of Health. Nov. 2019, www.aha.org/system/files/2018-04/value-initiative-icd-10-code-social-determinants-of-health.pdf.

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.