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Harvard Pilgrim Health CareMedicare Advantage · Documentation · CodingMedium impact

Using ICD-10 Z codes to track social drivers of health

Act
immediately
Effective date
Not stated in the notice
Identified
Jun 26, 2026

Summary

Point32Health is encouraging providers to use ICD-10 Z codes to document social drivers of health (SDOH) such as housing insecurity, food insecurity, transportation barriers, and employment issues when submitting claims. This policy aims to help identify vulnerable members and connect them to community resources, with documentation occurring during patient registration, routine exams, or condition-specific visits.

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What to do

immediately · 6 steps
01Billing and clinical teams must implement screening and documentation processes for social drivers of health.
02Clinical staff: Develop SDOH screening questions to ask during patient registration and routine visits; document findings in patient records.
03Providers: Begin including relevant Z codes (Z55, Z56, Z57, Z59, Z60, Z62, Z63, Z64, Z65, Z75) on all applicable claims submitted to Point32Health.
04Billing team: Update claim submission procedures to ensure Z codes are captured and transmitted; train staff on proper Z code selection based on documented SDOH factors (housing, food insecurity, transportation, employment, family circumstances, etc.).
05All staff: Reference the Social Drivers of Health Quick Reference Guide for comprehensive Z code options.
06Claims with properly documented and coded SDOH information will help Point32Health identify at-risk members; failure to document and code SDOH may result in missed opportunities for member outreach and resource connection.

Codes mentioned

Z55Z56Z57Z59Z60Z62Z63Z64Z65Z75

Original notice

Using ICD-10 Z codes to track social drivers of health
point32health.org · Always check the source before changing claims.
View original ↗

Related policy hubs

Harvard Pilgrim Health Care policiesCode Z55Code Z56Code Z57Code Z59Code Z60Code Z62Code Z63Code Z64Code Z65Code Z75

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