Coders play a vital role in shaping the future!

Posted by: Cindy Pedersen at May 12, 2023

As coders, we focus on accurately coding for reimbursement, statistics, research, and efficient interoperability. Still, when considering our profession from a human perspective, we capture the story of the patient. We now have additional options to fully report the socio-economic details of patients, which research suggests strongly impacts access to healthcare and the quality of life and health ICD-10-CM approved and published new social determinant Z codes on 4/1/2023.

AHIMA recently published a final report, Social Determinants of Health Data: Survey Result on the Collection, Integration, and Use, and their key findings were interesting. They found that many HIM professionals felt they lack the knowledge to code and analyze social determinant codes and their data successfully. Another discovery was that the information generated from the codes does not have a method of communication among healthcare providers. With the new code sets, the coders can report details about the patient’s housing situation, employment issues and risks, social environment details, issues during childhood, and other socio-economic circumstances that may contribute to health conditions or lack of health treatments. AHIMA reported that UCLA reviewed 15,000 Emergency Department records and found that approximately 85% of visits potentially could have been treated as a minor condition had the patient sought treatment through a venue or outreach service providing access to lower acuity healthcare, such as health clinics, urgent care centers or primary care providers

Coders directly provided the data in the AHIMA/NORC study, reminding us we are at the forefront of the battle against health disparity, and our weapons in this battle are our awareness and reporting of social determinant codes. Coders must be diligent in fully understanding and capturing these codes when documented, including looking at the record comprehensively since all clinicians (not just physicians) can provide the documentation to support coding the social determinants of health codes. As better and broader healthcare options are developed for the underserved populations, remember the role of coders in achieving these improved outcomes.

Read more about the AHIMA report here: https://ahima.org/media/03dbonub/ahima_sdoh-data-report.pdf

Joanne Brockman, RHIA, CCS, Vice President, Health Information Management Services
Leah Jeffries, RHIT, CDIP, CCS, CCS-P, Director of Coding- Strategic Accounts