Coding Tips: Social Determinants of Health (SDOH)

by | May 2, 2023 | Coding Tips, Education & Training

Coding Corner
In 2021, Social Determinants of Health (SDOH) were added as risk factors to the CPT table used to determine the level of medical decision-making for evaluation and management (E/M) services provided during visits in an office or other outpatient settings. As of Jan. 1, 2023, the same table was added for E/M services delivered in other settings, including inpatient, observation care, emergency departments, nursing facilities, and at a patient’s home or residence. Remember, not only the provider’s documentation is valid for the capture of SDOH codes. Often nurses, social workers, or case managers document this information on a patient’s record.

This link provides a great resource from CMS in regard to the use of SDOH codes: https://www.cms.gov/files/document/zcodes-infographic.pdf

What are SDOH?

According to Healthy People 2030, social determinants of health (SDOH) are the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

SDOH can be grouped into five domains:

Looking for coding help?

Learn more about Intellis IQ coding services. Our solutions are leading the way in the HIM industry.

Intellis coding education

Need help earning CEUs or educating your team? Visit the Intellis IQ Education Center and get your free account.

Intellis is dedicated to elevating the business of healthcare. We are committed to offering support and the most current information and updates to collaborate with coding and CDI professionals to realize their fullest potential. We enthusiastically seek opportunities to develop ourselves and each other. We understand that knowledge is the key to success for our clients navigating the ever-changing health information management landscape.

Our team offers quarterly coding clinic reviews, coding clinic reviews for CDI, and other valuable courses.