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24-396m Use the Most Descriptive SDOH Z Codes on Claims and Encounters
Act
immediately
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Healthcare providers must now use the most specific Social Determinants of Health (SDOH) Z codes (Z55-Z65) when documenting patient circumstances on claims and encounters. For categories Z55, Z58, Z59, and Z62, providers must drill down to the most descriptive subcodes rather than using general category codes.
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What to do
immediately · 4 steps
01Providers and coding staff must update documentation practices to use the most specific SDOH Z codes available.
02For Z55, Z58, Z59, and Z62 categories, drill down to subcodes instead of using general category codes.
03Update EMR templates and coding guidelines to require specific Z codes like Z59.12 for inadequate housing utilities instead of Z59.1 for general inadequate housing.
04Train staff on proper SDOH code selection to improve care coordination and health disparity identification.
Codes mentioned
Z55Z56Z57Z58Z59Z60Z62Z63Z64Z65Z59.12Z59.1
Original notice
24-396m Use the Most Descriptive SDOH Z Codes on Claims and Encounters
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.
Related changes
See all Health Net changes →24-397m Use the Most Descriptive SDOH Z Codes on Claims and EncountersMediumNo effective date · Prior Authorization24-395m Use the Most Descriptive SDOH Z Codes on Claims and EncountersMediumNo effective date · Coding25-1166m Integrating Social Determinants of Health Into Clinical PracticeMediumNo effective date · Reimbursement25-1168m Integrating Social Determinants of Health Into Clinical PracticeMediumNo effective date · ReimbursementBrowse every Health Net change in the policy list