SDoH – Social Determinants of Health

Awareness in the healthcare arena for SDoH (Social Determinants of Health) showed up in the AMA revamped the E/M codes for the office/clinic setting in 2021. It was introduced to medical coders as an added bullet in the risk category for moderate MDM (Medical Decision Making). Since then, there has been a substantial campaign to raise awareness, and provide clinical screening tools. Though the precise areas defined as SDoH vary from article to article, I can say that the headers below constitute the general consensus. Due to the slight variability, I researched both local and national resources.

The Harris County Medical Society has listed SDoH resources on their page. Tools found here assist clinicians with screening and identifying areas of SDoH, especially in the underserved patient population. As coders, auditors, and clinical documentation integrity professionals, these tools also provide a framework of what we should expect to see in clinical documentation needed to support the appropriate ICD-10-CM (diagnosis) and CPT (procedure) codes surrounding SDoH.

Below are some of the most common areas, though not an all-inclusive list.

Economic Instability

Food Insecurity
Housing
Employment
Transportation
Trouble Paying for Prescription(s)

Education Access and Quality

Opportunities for Trade School or Higher Education
- Financial Aid
- Help paying for books, clothes, supplies, transportation

Healthcare Access and Quality

Medical
Mental
Dental
End of Life

Neighborhood and Built Environment

Housing, Temporary Shelter, Maintenance and Repairs

The AAFP (American Academy of Family Physicians) has created a resource page where you can plug in your zip code to find financial assistance, food pantries, medical care, and other free or reduced-cost help in your area.

Neighborhood Help Graphic

Social and Community Context

Family and Social Support
Personal Safety
Partner Violence

This is a very basic overview of the SDoH. To get a better understanding, I encourage everyone to click around on the HCMS SDoH page, and visit the AAFP – Neighborhood Help Navigator. It is very interesting to see the variety of help programs available by zip code.

There’s more to SDoH than the MDM grid. Check back soon for a follow-up article on ICD-10-CM and CPT coding.