Utilization of Z Codes for Social Determinants of Health among Medicare Fee-for-Service Beneficiaries

Authors: Centers for Medicare & Medicaid Services: Office of Minority Health
Year: 2021
State: NatDoc: National Document
Website link: https://nachw.org/wp-content/uploads/2023/03/Z-Codes-Data-Highlight_2021-10-12.pdf
Publicly Available: Yes
Evidence Generation: Evidence-based interventions
Sustainable Financing: CMS and CDC engagement from a national level, How to engage and work with Medicaid, Billing/CPT codes, Education to HC orgs on payment options bundled etc., National-level guidance
Workforce Development: CDC expand CHW work into SDOH, Data sharing between social services and clinical teams

Z codes are a set of ICD-10-CM codes used to report social, economic, and environmental determinants known to affect health and health-related outcomes. Z codes are a tool for identifying a range of issues related – but not limited – to education and literacy, employment, housing, ability to obtain adequate amounts of food or safe drinking water, and occupational exposure to toxic agents, dust, or radiation. Z codes can be used in any health setting (e.g.,doctor’s office, hospital, skilled nursing facility (SNF) and by any provider (e.g., physician, nurse practitioner). There are nine broad categories of Z codes that represent various hazardous social, economic, and environmental conditions, each with several sub-codes. This data highlight provides an update to the past-published data highlight focused on Z code claims for Medicare fee-for-service (FFS) beneficiaries in 2017 . The study objectives are as follows: (1) Describe the number of total Z code claims and the proportion of continuously enrolled beneficiaries with Z code claims in 2016, 2017, 2018, and 2019.(2) Report the top five most utilized Z codes in 2019.(3) Describe the proportions of beneficiaries with Z codes across various sociodemographic characteristics, including dual eligibility status for Medicare and Medicaid, age, sex, and race and ethnicity, as well as the proportions of beneficiaries with Z codes across urban/rural strata.(4) Characterize the top five states with the largest shares of all Z code claims as well as proportion of Z code claims by claim type, service category, and provider/supplier type.(5) Highlight potential strategies that may aid in increasing utilization of Z codes representing key social, environmental, and economic risks to health.

Download from original source

Download from DRC website