CMS Adds New ICD-10-CM Z Codes: What You Need to Know

Earlier this month, The Centers for Medicare and Medicaid Services (CMS) Office of Minority Health released an infographic with new ICD-10-CM Z Codes. New updates become effective each April and October with the newest updates going into effect on October 1, 2023. CMS’s expansion of Z codes within the ICD-10-CM system demonstrates a commitment to capturing a broader spectrum of factors that influence member health. This year alone we have seen dozens of Z codes added for barriers related to health literacy, physical environment and housing inadequacies, and transportation challenges (to name a few). New 2023 codes include:

• Z55.6 – Problems related to health literacy: Used when a member has difficulties understanding health-related information or medical instructions, and/or has problems completing medical forms.

• Z58.81 – Basic services unavailable in physical environment: Used when a member is unable to obtain internet and telephone services.

• Z59.82 – Transportation insecurity: Used when a member has unaffordable, unreliable, or unsafe transportation.

• Z59.11 – Inadequate housing environmental temperature: Used when a member’s living arrangement has a lack of heating or air conditioning.

• Z59.12 – Inadequate housing utilities: Used when a member’s living arrangement has a lack of water, oil, gas, or electricity services.

This expansion aligns with the healthcare industry’s ongoing effort to provide a holistic approach to member care, facilitating tailored/personal interventions, better outcomes, and improved member satisfaction. BeneLynk applauds CMS for its Z code expansion efforts and looks forward to the addition of more Z code expansions as CMS continues to empower healthcare providers to deliver targeted care and more accurate documentation in the future.

BeneLynk, an early adopter of Z codes, is passionate about accurately documenting social health barriers. Z code documentation lies at the heart of what we do.

BeneLynk begins outreach efforts with a comprehensive assessment of social needs. From there, answers are documented using Z codes, and how we solve those challenges is seamlessly mapped to LOINC and SNOMED. We believe that the documentation of challenges should be paired with an immediate plan to address these challenges by connecting members to meaningful benefit programs and resources that address their specific needs.

BeneLynk reports all findings to health plans in a member detail SDoH report. It is crucial that health plans communicate the SDoH risks of an individual to all stakeholders in a structured, unambiguous way that can facilitate interventions to address their risks while tracking outcomes. This also allows health plans to meet the requirements of the SNS-E measure and see trends that allow you to explore actionable insights to improve quality, care coordination, risk-adjusted revenue, and member experience.

To learn more about BeneLynk’s use of Z codes to document social care needs, drop us a note at Keslie@BeneLynk.com.