Moving Z Codes to the Front of the List

Health Equity Matters Part 2

When it comes to health equity, Social Determinants of Health (SDOH) are now being recognized as a major player in health outcomes. When the first Z Codes were released to begin collecting some of this important data, the priority was low, especially without reimbursement tied to the codes. But things have changed. The importance behind them is now backed by billing, more codes have been added October 1 with more on the way, and progress continues on standardization. It’s time to move Z Codes to the front of the list and make a bigger impact on public health.


SDOH are the conditions in peoples’ environments that affect health outcomes, such as neighborhood and housing, food security, and transportation. SDOH Z Codes range from Z55-Z65 and are reported as secondary diagnoses. Because these codes represent social information and not medical diagnoses, the guidelines have been changed to allow reporting based on medical documentation from other clinician’s involved in the care of the patient, such as case managers, social workers, and nurses.

What We Have to Gain

We collect an incredible amount of data with each patient visit, but SDOH can be some of the most meaningful data yet. Accurately capturing this information can help:

  • More Personalized Care
    Tracking social needs identifies what personalized care will address a specific patient’s medical and social needs.
  • Social Determinants Strategy
    Aggregate data can help us determine how and where to focus on bigger social issues in localized areas.
  • Build Stronger CommunitiesThe data shows population health trends and can guide community partnerships and public health management.

Challenges to Collecting SDOH Data

Collecting and documenting SDOH data does not come without its challenges to operations and coding productivity, and there are quite a few, including:



We know quality documentation leads to more accurate coding, but it can be somewhat confusing on where to find quality data in the medical records that relates directly to the SDOH code. Organizations also need to identify who is collecting the data from the patient, what type of data, and when it should be collected. Having a framework in place is crucial to implement this task.


Coding Productivity

An AHIMA 2020 survey showed 27% of respondents found coding productivity standards a key challenge in collecting SDOH data. Institutions can’t agree on which SDOH elements should be prioritized, and a lack of standardization impacts coding productivity, among other things.


Organizational Policy

The same AHIMA survey also cited a lack of organizational policy around SDOH data collection. All collected data must have an intended purpose within the EHR workflow to demonstrate value in improving patient experience and/or health outcomes.


Education and Training

Every person involved in collecting and coding SDOH data needs additional education and training to understand the needs behind the data, exactly what data to capture, and how to code it correctly. With processes and standardization still being worked out on a larger level, everyone needs to be constantly up to date with the latest requirements.

Working Together for a Better Future

We know that you want to provide the best patient care possible, but any extra step in the process can be frustrating. However, not collecting SDOH data can end up in missed appointments, preventable health events, and reduced care plan completion. AQuity’s Medical Coding Services will keep you in compliance so your patients receive the best outcomes possible.


Our credentialed medical coders already have the knowledge and experience to handle Z Codes. They can quickly locate the necessary data, ensure proper validation, and apply the appropriate code. AQuity will work within your individual organization’s policies and procedures, as well as provide feedback and education to team members on how to improve workflow. We also provide Medical Coding Audits to ensure you’re meeting requirements while optimizing justifiable reimbursements.


There’s no doubt that proper collection and use of SDOH data comes with extra challenges outside of the regular scope of medical care. However, we know that the end results will be more than worth it. We can help your organization collect and code the right data so that you can provide your patients with better whole person care, and together, we can improve health equity.

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