DecisionHealth, DecisionHealth - 2021 Issue 8 (August)

Don’t chain social determinants of health for MDM risk to ICD-10-CM codes

Question: We are considering the following policy for E/M visits: Coders can’t select moderate risk because a social determinant of health (SDOH) affected the diagnosis or treatment, unless the note supports an SDOH diagnosis code from the Z55-Z65 range (Persons with potential health hazards related to socioeconomic and psychosocial circumstances). That way we can make sure the risk level is supported by the note.

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