Are you coding SDOH (Social Determinants of Health) codes? If not, you will want to start!
In the FY 2024 Hospital IPPS (Inpatient Prospective Payment System) proposed rule, CMS wants to change the severity designation of three ICD-10-CM diagnosis codes from non-complication or comorbidity (NonCC) to complication or comorbidity (CC), based on the higher average resource costs of cases with these diagnosis codes compared to similar cases without these codes.
- 00 Homelessness unspecified
- 01 Sheltered Homelessness
- 02 Unsheltered Homelessness (e.g., unspecified, sheltered, and unsheltered)
Official Coding Guidelines state that this information may be coded from clinician documentation other than a provider. These clinicians are healthcare professionals permitted to document in a patient’s official medical record.
Coding Clinic states to code as many SDOH codes as necessary to describe all documented risk factors for the patient. However, these codes should only be assigned when there is a documented associated problem or risk factor. For example, not every person living alone would be assigned Z60.2, Problems related to living alone.
References
Coding Clinic, 4th Qtr. 2021, pgs. 81-84
Coding Clinic, 4th Qtr. 2022, pgs. 86-87
CMS: FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Proposed Rule – CMS-1785-P; Apr 10, 2023; Medicare Parts A & B
